ATC Abstracts

American Transplant Congress abstracts

  • Home
  • Meetings Archive
    • 2022 American Transplant Congress
    • 2021 American Transplant Congress
    • 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
    • 2021 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
  • Search

Interstitial Inflammation with Chronic Allograft Injury Best Predicts Graft Loss

M. Ajaimy, M. Parides, A. Colovai, Y. Azzi, L. Liriano Ward, P. Nandigam, J. Rocca, M. Kinkhabwala, S. Greenstein, J. Graham, E. Akalin

Einstein-Montefiore Transplant Center, Bronx, NY

Meeting: 2020 American Transplant Congress

Abstract number: 454

Keywords: Biopsy, Fibrosis, Graft failure, Inflammation

Session Information

Session Name: Kidney Complications: Immune Mediated Late Graft Failure

Session Type: Oral Abstract Session

Date: Saturday, May 30, 2020

Session Time: 3:15pm-4:45pm

 Presentation Time: 4:15pm-4:27pm

Location: Virtual

*Purpose: We aimed to identify clinical, serological and histopathological predictors of graft loss in kidney transplant recipients who underwent clinically indicated graft biopsies for worsening kidney function and/or proteinuria. We especially aimed to investigate the effect of interstitial inflammation on allograft outcome.

*Methods: We retrospectively evaluated 516 patients who underwent kidney transplant biopsy between January 2009 and January 2018. Acute and chronic allograft injury scores of Banff classification were used. We sub grouped the patients with chronic allograft injury score (ci+ct+cv) ≥ 3 or < 3 and sub grouped per interstitial inflammation (i score=0 and > 0) and compared to biopsies with both ci+ct+cv and i=0. Anti-HLA antibodies were studied using Luminex SAB at the time of the biopsy

*Results: Transplant kidneys biopsies are done at a median 12.5 months after kidney transplantation. The histopathological diagnosis were as following: acute antibody-mediated rejection (AMR) (6%), acute T-cell mediated rejection (9.3%), chronic AMR (6.7%), transplant glomerulopathy without donor-specific antibody (DSA) (10.2%), recurrent/de novo glomerular disease (10.8%), BKV nephropathy (2.5%), and the rest 54.2% had other diagnosis (normal, acute tubular necrosis, or non-specific interstitial fibrosis/tubular atrophy). During a median follow up of 59.3 months after kidney biopsy, 36 %recipients lost their graft. In univariate analysis, the following factors were significant for graft loss: Black race (p=0.005), previous rejection (p<0.0001), DSA at the time of biopsy (p=0.014), DSA-B (p=0.0017), DSA-C (p=0.016), DSA-DQ (p=0.0021), DSA-DR (p=0.039), ci+ct+cv ≥ 3 (p=0.0485), ci+ct+cv ≥ 3 with interstitial inflammation > 0 ( p<0.0001), microvascular inflammation (p=0.0052), C4d positivity ( p=0.008), serum creatinine at time of the biopsy (p<0.0001), and spot urine protein/creatinine ( <0.0001). In the multivariate analysis ci+ct+cv < 3 with i>0 has the highest hazard ratio followed by ci+ct+cv ≥ 3 with i>0, ci+ct+cv ≥ 3 with i=0, black race, serum creatinine, and spot urine protein/creatinine

*Conclusions: Interstitial inflammation on top of chronic allograft injury is the best predictor for allograft loss after clinically indicated kidney biopsy regardless of the severity of chronic allograft injury score. We suggest that Interstitial inflammation on top of chronic allograft injury should be validated and recognized in the future revision of Banff classification

Risk Factor HR 95% CI P-value
ci+ct+cv < 3 with i>0 8.38 3.22-21.78 <0.0001
ci+ct+cv ≥ 3 with i>0 2.92 1.47-5.28 <0.0001
ci+ct+cv ≥ 3 with i=0 2.69 1.33-5.44 <0.0001
Black Race 2.04 1.43-2.89 <0.0001
Serum Creatinine 1.27 1.18-1.37 <0.0001
Spot Urine protein/creatinine 1.11 1.06-1.17 <0.0001
  • Tweet
  • Email
  • Print

To cite this abstract in AMA style:

Ajaimy M, Parides M, Colovai A, Azzi Y, Ward LLiriano, Nandigam P, Rocca J, Kinkhabwala M, Greenstein S, Graham J, Akalin E. Interstitial Inflammation with Chronic Allograft Injury Best Predicts Graft Loss [abstract]. Am J Transplant. 2020; 20 (suppl 3). https://atcmeetingabstracts.com/abstract/interstitial-inflammation-with-chronic-allograft-injury-best-predicts-graft-loss/. Accessed May 11, 2025.

« Back to 2020 American Transplant Congress

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 © 2013-2025 by American Society of Transplantation and the American Society of Transplant Surgeons. All rights reserved.

Privacy Policy | Terms of Use | Cookie Preferences