The impact on graft survival of interstitial inflammation in borderline change of allograft kidneys

Nephrology (Carlton). 2014 Jun:19 Suppl 3:17-20. doi: 10.1111/nep.12242.

Abstract

Aim: In kidney transplantation cases, borderline change (BL) can lead to a progressive course. However, factors related to outcome and the progress of BL are not well defined. In this study, we focused specifically on interstitial inflammation as a factor influencing outcome after diagnosis of BL.

Methods: We followed 252 recipients who underwent renal transplantation between 1998 to 2012 at our hospital. Of those, we retrospectively studied 40 diagnosed with BL from allograft biopsy findings, and then classified them as BL1 and BL2 according to the level of interstitial inflammation (i) (BL1: i < 10%, BL2: i ≥ 10%).

Results: There were 21 BL1 and 19 BL2 cases, of whom 7 developed rejection during the follow-up period. There were no significant differences for graft survival rate and the rate leading to acute rejection between the 2 groups (P = 0.44, P = 0.69). Univariate analysis showed that the grade of interstitial inflammation was not a significant risk factor for developing acute rejection (P = 0.816).

Conclusion: Our results show that the level of interstitial inflammation does not have an effect on a progressive BL course.

Keywords: borderline change; interstitial inflammation; renal transplantation.

MeSH terms

  • Adult
  • Aged
  • Biopsy
  • Female
  • Graft Rejection / drug therapy
  • Graft Rejection / immunology*
  • Graft Rejection / pathology*
  • Graft Survival / immunology*
  • Humans
  • Immunosuppressive Agents / therapeutic use
  • Kidney Transplantation / adverse effects*
  • Male
  • Middle Aged
  • Nephritis, Interstitial / immunology*
  • Nephritis, Interstitial / pathology*
  • Retrospective Studies
  • Steroids / therapeutic use
  • Transplantation, Homologous
  • Young Adult

Substances

  • Immunosuppressive Agents
  • Steroids