ATC Abstracts

American Transplant Congress abstracts

  • Home
  • Meetings Archive
    • 2020 American Transplant Congress
    • 2019 American Transplant Congress
    • 2018 American Transplant Congress
    • 2017 American Transplant Congress
    • 2016 American Transplant Congress
    • 2015 American Transplant Congress
    • 2013 American Transplant Congress
  • Keyword Index
  • Resources
    • 2016 Resources
      • 2016 Welcome Letter
      • ATC 2016 Program Planning Committees
      • ASTS Council 2015-2016
      • AST Board of Directors 2015-2016
    • 2015 Resources
      • 2015 Welcome Letter
      • ATC 2015 Program Planning Committees
      • ASTS Council 2014-2015
      • AST Board of Directors 2014-2015
      • 2015 Conference Schedule
  • Advanced Search

100 Protocol Renal Allograft Biopsies at 10 Years: First Look at the Tacrolimus Era

M. Stegall,1 W. Park,1 F. Cosio,2 L. Cornell.3

1Transplant Surgery, Mayo Clinic, Rochester, MN
2Medicine, Mayo Clinic, Rochester, MN
3Laboratory Medicine, Mayo Clinic, Rochester, MN.

Meeting: 2015 American Transplant Congress

Abstract number: B109

Keywords: Glomerular filtration rate (GFR), Graft failure, Kidney transplantation, Renal injury

Session Information

Date: Sunday, May 3, 2015

Session Name: Poster Session B: Kidney Complications: Late Graft Failure

Session Time: 5:30pm-6:30pm

 Presentation Time: 5:30pm-6:30pm

Location: Exhibit Hall E

Related Abstracts
  • Banff Criteria Are Inadequate to Assess Chronic Renal Allograft Injury 10 Years Post-Transplantation
  • Long-Term Impact of CMV Infection on the Allograft and on Patient Survival in Renal Transplant Patients with Protocol Biopsies

This study examined late renal allograft injury in the Tacrolimus era in 10-yr protocol biopsies (Bx).

Methods One hundred 10-yr protocol allograft bx were assessed using Banff scores/conventional pathology. Between 1/1/2002 and 8/1/2004, 449 adult solitary KTx were performed: 236 did not reach 10 years (101 DWF, 78 Failed, 85 lost to follow-up) leaving 185 KTx, 100 were biopsied. Iothalamate GFR was done in 88% at 5 and 10 yrs. Demographics: Caucasian (93%), male (56%), living donor KTx (83%), Thymoglobulin induction (94%) and Tac, MMF, Pred at 10 yrs (77%).

Results 23% of Bx had only mild chronic changes (cg=0 and chronic scores <1). This group had the highest GFR and lowest proteinuria. 13% had transplant glomerulopathy and 9% had moderate-to-severe interstitial fibrosis (and no cg) with the lowest GFR. In biopsies without cg (n=87), arteriolar hyalinosis was present in 90% (55 were >1) and 68% had increased from 5 years. Global glomerular sclerosis involving >20% of glomeruli was present in 43%. Subclinical inflammation was found in only 4% and recurrence of the primary renal disease was observed in 7%. Importantly, diabetic nephropathy was common (35%), but was not associated with decreased GFR (?hyperfiltration). From 5 to 10 years, 47% had a GFR decline of >10% and 23% an increase >10%. GFR decline was most common in grafts with interstitial fibrosis but not with arteriolar hyalinosis or diabetic nephropathy. 13 had DSA: 4 cg>0, 6 ah>1, 2 cv>1 and 2 only mild changes.

Conclusions 10 yr bx in the Tac era showed a low prevalence of mod/severe fibrosis, TG and subclinical inflammation. The fact that hyalinosis and diabetic nephropathy were common suggests that new approaches to patient management and immunosuppression are warranted to prevent late injury.

Banff Lesions     GFR ml/min δGFR 5/10y 24 hr protein
No Lesions>1(ci/ct/cv/ah≤1; cg=0) 23   66±24 99%±21% 96±26
Transplant glomerulopathy (cg=0) 13   51±25 82%±27% 1760±2648
Mod-Severe Changes (cg=0; other chronic lesions>1) 64        
Interstitial fibrosis (ci>1; cg=0)   9 41±20 64%±25% 1746±2851
Arteriolar hyalinosis (ah>1; cg=0)   55 62±26 95%±32% 468±1216
Arterial sclerosis (cv>1; cg=0)   28 59±21 94%±30% 358±856
Other Diagnoses (in addition to Banff Scores)          
Diabetic nephropathy/mesangial sclerosis; (cg=0)   35 65±29 92%±32% 333±767
Recurrent disease (cg=0)   7 59±28 81%±22% 1166±2914
Sub-clinical inflammation (i&ci>0; cg=0)   4 42±17 78%±11% 460±492
  • Tweet
  • Email
  • Print

To cite this abstract in AMA style:

Stegall M, Park W, Cosio F, Cornell L. 100 Protocol Renal Allograft Biopsies at 10 Years: First Look at the Tacrolimus Era [abstract]. Am J Transplant. 2015; 15 (suppl 3). https://atcmeetingabstracts.com/abstract/100-protocol-renal-allograft-biopsies-at-10-years-first-look-at-the-tacrolimus-era/. Accessed March 8, 2021.

« Back to 2015 American Transplant Congress

Most Viewed Abstracts

  • This Week
  • This Month
  • All Time
  • Home
  • Subtherapeutic Low Tacrolimus Trough Levels (≤3.5 Ng /ml) Are A Risk Factor For Acute Rejection And Creatinine Doubling.
  • Low GFR after Kidney Donation Is Not Chronic Kidney Disease
  • Search
  • Is There a Difference Between DCD and DBD Kidney Transplantation with Similar KDPI?
  • Low GFR after Kidney Donation Is Not Chronic Kidney Disease
  • Home
  • Subtherapeutic Low Tacrolimus Trough Levels (≤3.5 Ng /ml) Are A Risk Factor For Acute Rejection And Creatinine Doubling.
  • Penis Transplantation: First U.S. Experience.
  • A Decade of Donor-Derived Disease: A Report of the OPTN Ad Hoc Disease Transmission Advisory Committee (DTAC).
  • Penis Transplantation: First U.S. Experience.
  • Is There a Difference Between DCD and DBD Kidney Transplantation with Similar KDPI?
  • Low GFR after Kidney Donation Is Not Chronic Kidney Disease
  • Evidence of a Clinically Significant Drug-Drug Interaction between Cannabidiol and Tacrolimus: A Case Report
  • Kidney Dialysis after Heart Transplantation: The Short and Long Term Outcomes

Visit Our Partner Sites

American Transplant Congress (ATC)

Visit the official site for the American Transplant Congress »

American Journal of Transplantation

The official publication for the American Society of Transplantation (AST) and the American Society of Transplant Surgeons (ASTS) »

American Society of Transplantation (AST)

An organization of more than 3000 professionals dedicated to advancing the field of transplantation. »

American Society of Transplant Surgeons (ASTS)

The society represents approximately 1,800 professionals dedicated to excellence in transplantation surgery. »

Copyright © 2013-2021 by American Society of Transplantation and the American Society of Transplant Surgeons. All rights reserved.

Privacy Policy

loading Cancel
Post was not sent - check your email addresses!
Email check failed, please try again
Sorry, your blog cannot share posts by email.
This site uses cookies: Find out more.