Date: Sunday, May 3, 2015
Session Time: 5:30pm-6:30pm
Presentation Time: 5:30pm-6:30pm
Location: Exhibit Hall E
We and others have shown late DCGF is due to ongoing, most often immune, injury. Though there is general agreement that antibody-mediated injury is a common cause of late DCGF, the impact of cell-mediated immunity remains controversial. In this prospective, multicenter study, 559 pts underwent for-cause biopsies 7.9±5.8 years post-txp for new-onset graft dysfunction or proteinuria, with 235 having both central DSA determination, and biopsy (bx) read by a blinded pathologist according to 2007 Banff criteria. MIA was characterized by quantitative g (glomerulitis) and ptc (peritubular capillaritis) scores; other inflammation by i (interstitial) and t (tubulitis) scores. Pts with DSA, C4d, or both were more likely to have g (p=0.04) and ptc (p<0.001) scores ≥ 1. By univariate analysis, DSA (HR=2.9), C4d (HR=3.1), both DSA/C4d (HR=4.3), g (HR≥1.8), ptc (HR≥2.4), combined g+ptc score (HR≥2.7), i (HR≥1.5), and t (HR≥1.8) were all associated with increased risk for DCGF, as were time after transplantation and serum creatinine at bx. Multivariate analysis demonstrated a significant, independent impact of DSA/C4d classification, MIA, and i, but not t, scores on risk for DCGF.
|Serum creat at bx||<0.0001|
|Years post txp||0.01|
To cite this abstract in AMA style:Gaston R, Fieberg A, Leduc R, Connett J, Cosio F, Gourishankar S, Grande J, Hunsicker L, Kasiske B, Cecka J, Matas A, Rush D. Microvascular (MIA) and Interstitial (i) Inflammation Influence Late Death-Censored Graft Failure (DCGF) After Kidney Transplantation [abstract]. Am J Transplant. 2015; 15 (suppl 3). https://atcmeetingabstracts.com/abstract/microvascular-mia-and-interstitial-i-inflammation-influence-late-death-censored-graft-failure-dcgf-after-kidney-transplantation/. Accessed April 15, 2021.
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