Session Type: Poster Session
Date: Saturday, May 2, 2015
Session Time: 5:30pm-7:30pm
Presentation Time: 5:30pm-7:30pm
Location: Exhibit Hall E
Previous reports have described an increase in arteritis during acute rejection (AR) in angiotensin II type 1 receptor antibody (AT1Rab) positive (ve+) kidney transplant recipients (KTR). This study aimed to analyze the histological findings at time zero (T0), acute rejection (AR), and 12 mo protocol biopsies (Bx) from pre-transplant AT1Rab+ve (without HLA-DSA) kidney transplant recipients (KTR), and in a group of KTR with neither AT1Rab nor HLA-DSA pre-KT. Methods: We previously reported the data from 111 living donor KTR (03/2009 to 08/2012) screened pre-KT for both AT1Rab and HLA-DSA abs. Of 111, 13 (11.7%) tested AT1Rab+ve (>17 IU) & HLA-DSA ve, and 90 tested ve for both AT1Rab and HLA-DSA (No Abs). For this study, all graft Bx´s obtained from 13 AT1Rab+ve KTR and 29 AT1Rab-ve/HLA-DSA-ve KTR [control group (CG) paired by donor & recipient age, gender and HLA-match] were blinded, reviewed and graded (Banff 2013) by a nephropathologist. Results: No pathological feature was different between the groups (Index: G, PTC, V, C4d and Cg) except for sub-intimal fibrosis, present in 4/4 AT1Rab+ve pts during AR; this finding persisted in 12mo protocol Bx´s compared to 1/11 AR Bx from a No Abs pt, (p=0.007), Figure 1.
Whether the finding of subintimal fibrosis in 100% of patients who experienced AR having AT1Rab maybe attributed to the effect of the abs deserves to be confirmed in a larger patient population study. Likewise, the potential impact of this vascular alteration in long-term graft outcome should be analyzed.
To cite this abstract in AMA style:González-Almada A, Arreola-Guerra J, Cuevas E, Vilatoba M, Contreras A, Sanchez-Cedillo A, Alberu J, Uribe-Uribe N. Histologic Findings in Pre-transplant AT1Rab + ve Patients Point to an Increase in Sub-Intimal Fibrosis During Acute Rejection and in 12 mo. Protocol Renal Graft Biopsies [abstract]. Am J Transplant. 2015; 15 (suppl 3). https://atcmeetingabstracts.com/abstract/histologic-findings-in-pre-transplant-at1rab-ve-patients-point-to-an-increase-in-sub-intimal-fibrosis-during-acute-rejection-and-in-12-mo-protocol-renal-graft-biopsies/. Accessed May 26, 2022.
« Back to 2015 American Transplant Congress