Kidney graft survival of >25 years: a single center report including associated graft biopsy results.
kidney clinical
outcome
surgery
Journal
Transplant international : official journal of the European Society for Organ Transplantation
ISSN: 1432-2277
Titre abrégé: Transpl Int
Pays: Switzerland
ID NLM: 8908516
Informations de publication
Date de publication:
Dec 2019
Dec 2019
Historique:
received:
29
09
2018
revised:
29
10
2018
accepted:
07
06
2019
pubmed:
13
6
2019
medline:
28
7
2020
entrez:
13
6
2019
Statut:
ppublish
Résumé
Only few centers have reported their observations on patients with very long-term kidney graft survival of more than 25 years. Eighty-six subjects were identified in our center with graft survival of >25 years. Donor age was 31.3 ± 18.5 years. Mean duration of transplantation was 30.3 ± 3.6 years. At last follow-up, the cystatin C clearance was 47 ± 23 ml/min. Transplant biopsies for cause were performed in 30 subjects at a median of 28.4 years (19.1-40.3) after transplantation. Acute or chronic active T cell-mediated rejection was present in five cases and histological characteristics of acute or chronic active humoral rejection in eight cases. More than 80% of biopsies had inflammatory infiltrates in nonatrophic or atrophic cortical areas. The number of HLA mismatches were higher in biopsied subjects (3.0 ± 1.8 vs. 2.2 ± 1.7 without biopsy). Immunosuppressive therapy was adapted in most biopsied subjects; impaired graft function and proteinuria was unchanged at last follow-up. Sixty percent of all subjects had hyperparathyroidism (iPTH of the whole group: 132 ± 157 pg/ml), which was predominantly secondary, as judged by serum calcium and graft function. Young donor age was certainly a prerequisite of longterm graft survival. Nonetheless, inflammation or rejection in most biopsied patients suggests an important role of alloreactivity even in this late course.
Substances chimiques
Immunosuppressive Agents
0
Parathyroid Hormone
0
Types de publication
Journal Article
Langues
eng
Sous-ensembles de citation
IM
Pagination
1277-1285Commentaires et corrections
Type : CommentIn
Type : CommentIn
Informations de copyright
© 2019 Steunstichting ESOT.
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