Hallazgos histológicos en biopsia por protocolo asociados con reducción en función renal 12 meses post trasplante en receptores de trasplante renal con bajo riesgo inmunológico recibiendo inducción con Basiliximab
Montero, Camilo | 2016-06-29
Introduction: Identifying factors that are associated of allograft function loss might be an important step toward prolonging kidney allograft survival.
Purpose: In this study we found to determine the association between histologic changes on 1-year surveillance biopsies and changes in graft function.
Methods: Recipients of kidneys from deceased donors or living donors trasplanted between 2007 and 2012. The primary end point was reduction in calculated glomerular filtration rate (Cockroft anf Gault) higher 5ml/min 12 months post transplant vs calculated glomerular filtration rate previous surveillance biopsie.
Results: This analysis included 114 adults, recipients of kidneys with low immunological risk receiving basiliximab induction from deceased donors (95%) or living donors (5%), transplanted between august 2007 and july 2012. The primary end point was reduction in calculated glomerular filtration rate (Cockroft & Gault) higher 5ml/min 12 months post trasplant . 25 of 114 patientes showing reduction; The histologic changes associated with renal function reduction were glomerulitis (p=0,024), interstitial inflamation (p=0,001), tubulitis (p=0,001), capilaritis (p=0,001), glomerulitis + capilaritis (p=0,001), polyoma virus nephropathy (p=0,04) and subclinical rejection (p=0,015). By regression analyses, interstitial inflamation (OR = 2,11; IC 95%: 1,13-3,95) and capilaritis (0R=7,12; IC 95%:1,57-32,27) were associated with renal function redcution 12 month post-transplant.
Conclusion: inflammation and capilaritis in protocol biopsies in first year post-transplant predict loss of graft function and independently of other variables.