PMID- 22310621
OWN - NLM
STAT- MEDLINE
DCOM- 20120524
LR  - 20151119
IS  - 1873-2623 (Electronic)
IS  - 0041-1345 (Linking)
VI  - 44
IP  - 1
DP  - 2012 Jan
TI  - Clinicopathologic analysis of acute vascular rejection cases after renal 
      transplantation.
PG  - 230-5
LID - 10.1016/j.transproceed.2011.11.002 [doi]
AB  - INTRODUCTION: Histopathologic change of acute vascular rejection (AVR) is 
      characterized by intimal arteritis and transmural arteritis. In this report, we 
      discuss the clinicopathologic analysis of AVR cases after renal transplantation. 
      PATIENTS: AVR was diagnosed in 28 renal transplant recipients followed up in our 
      institute between January 2003 and November 2010. RESULTS: Among 28 cases of AVR, 
      18 were mild (v1 in Banff 07 classification), 8 were moderate (v2), and 2 were 
      severe (v3). Interstitial inflammation was present in 25 biopsy specimens. 
      Moderate to severe tubulitis (t2-t3) was present in 10 biopsy specimens and 
      transplant glomerulitis in 17; peritubular capillaritis was in 25 of the 28 
      biopsy specimens. C4d deposition in peritubular capillaries was observed in 11/28 
      cases. By using assays with plastic beads coated with human leukocyte antigen 
      (HLA) in the 28 cases, we detected circulating anti-HLA alloantibody in 18 
      patients, among which 11/28 were donor-specific. Acute antibody-mediated 
      rejection was diagnosed in 6 cases. Among AVR cases, 19/28 displayed 
      steroid-resistant rejection (SRR) requiring greater anti-rejection therapy (ART), 
      including muromonab CD3 injection, gusperimus injections, plasmapheresis, 
      intravenous immune globulin, and/or rituximab injections. Twenty of 28 patients 
      recovered renal allograft function after ART, and 26/28 grafts are functioning. 
      Among the 2 cases of graft loss, only 1 patient lost his graft due to AVR. 
      CONCLUSIONS: In some cases, AVR might be provoked by anti-donor antibodies. The 
      prognosis of the graft exhibiting AVR was relatively good using available 
      immunosuppression.
CI  - Copyright (c) 2012 Elsevier Inc. All rights reserved.
FAU - Shimizu, T
AU  - Shimizu T
AD  - Department of Urology, Tokyo Women's Medical University, Tokyo, Japan.
FAU - Tanabe, T
AU  - Tanabe T
FAU - Omoto, K
AU  - Omoto K
FAU - Ishida, H
AU  - Ishida H
FAU - Tanabe, K
AU  - Tanabe K
LA  - eng
PT  - Journal Article
PL  - United States
TA  - Transplant Proc
JT  - Transplantation proceedings
JID - 0243532
RN  - 0 (Biomarkers)
RN  - 0 (HLA Antigens)
RN  - 0 (Immunosuppressive Agents)
RN  - 0 (Isoantibodies)
RN  - 0 (Peptide Fragments)
RN  - 80295-50-7 (Complement C4b)
RN  - 80295-52-9 (complement C4d)
RN  - AYI8EX34EU (Creatinine)
SB  - IM
MH  - Acute Disease
MH  - Adult
MH  - Aged
MH  - Arteritis/blood/*immunology/pathology/physiopathology/therapy
MH  - Biomarkers/blood
MH  - Biopsy
MH  - Complement C4b/analysis
MH  - Creatinine/blood
MH  - Drug Therapy, Combination
MH  - Female
MH  - Graft Rejection/blood/*immunology/pathology/physiopathology/therapy
MH  - *Graft Survival/drug effects
MH  - HLA Antigens/immunology
MH  - Humans
MH  - Immunosuppressive Agents/therapeutic use
MH  - Isoantibodies/blood
MH  - Japan
MH  - Kaplan-Meier Estimate
MH  - Kidney/*blood supply/drug effects/*immunology/pathology/physiopathology
MH  - Kidney Transplantation/*immunology
MH  - Male
MH  - Middle Aged
MH  - Peptide Fragments/analysis
MH  - Plasmapheresis
MH  - Recovery of Function
MH  - Retrospective Studies
MH  - Severity of Illness Index
MH  - Time Factors
MH  - Treatment Outcome
MH  - Young Adult
EDAT- 2012/02/09 06:00
MHDA- 2012/05/25 06:00
CRDT- 2012/02/08 06:00
PHST- 2012/02/08 06:00 [entrez]
PHST- 2012/02/09 06:00 [pubmed]
PHST- 2012/05/25 06:00 [medline]
AID - S0041-1345(11)01547-8 [pii]
AID - 10.1016/j.transproceed.2011.11.002 [doi]
PST - ppublish
SO  - Transplant Proc. 2012 Jan;44(1):230-5. doi: 10.1016/j.transproceed.2011.11.002.