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Morphologic Patterns and Treatment of Transplant Glomerulopathy: a Retrospective Analysis

2017Journal article Open access
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dc.contributor.authorAbreu, R
dc.contributor.authorCarvalho, F
dc.contributor.authorViana, H
dc.contributor.authorMesquita, I
dc.contributor.authorPossante, M
dc.contributor.authorAires, I
dc.contributor.authorCaeiro, F
dc.contributor.authorSilva, C
dc.contributor.authorCotovio, P
dc.contributor.authorFerreira, A
dc.contributor.authorRemédio, F
dc.contributor.authorNolasco, F
dc.date.accessioned2021-08-13T13:28:40Z
dc.date.available2021-08-13T13:28:40Z
dc.date.issued2017
dc.description.abstractTransplant glomerulopathy is mainly due to chronic antibody-mediated rejection and actually represents a major cause of long-term allograft failure. The lack of effective treatment remains a serious problem in transplantation. A retrospective and uni-center study was performed in 48 kidney allograft recipients with transplant glomerulopathy between January 2010 and December 2015. Median time for diagnosis was 7.1 (3.6-11.8) years post-transplant. Light microscopy showed severity of transplant glomerulopathy in the majority of patients (cg1=10.4%; cg2=20.8%; cg3=68.8%). Moderate microvascular inflammation was present in 56.3% (g+ptc≥2), and almost half of recipients (51.1%) were C4d positive in immunofluorescence. Female gender (P=.001), age (P=.043), renal dysfunction (P=.002), acute rejection episodes (P=.026), and anti-HLA class II antibodies (P=.004) were associated with kidney allograft failure. Treatment of transplant glomerulopathy was performed in 67.6% of patients. The histologic and laboratory features that led to a therapeutic intervention were score ptc (P=.021), C4d (P=.03), and the presence of anti-HLA antibodies (P=.029), whereas score ah (P=.005) was associated with conservative measure. The overall cumulative kidney allograft survival at 10 years was 75%. Treatment of transplant glomerulopathy was ineffective to improve long-term kidney allograft survival.pt_PT
dc.description.versioninfo:eu-repo/semantics/publishedVersionpt_PT
dc.identifier.citationClin Transplant. 2017 Apr;31(4). doi: 10.1111/ctr.12915. Epub 2017 Feb 21.pt_PT
dc.identifier.doi10.1111/ctr.12915.pt_PT
dc.identifier.urihttp://hdl.handle.net/10400.17/3832
dc.language.isoengpt_PT
dc.peerreviewedyespt_PT
dc.publisherWileypt_PT
dc.subjectHCC NEFpt_PT
dc.subjectAdultpt_PT
dc.subjectFemalept_PT
dc.subjectMalept_PT
dc.subjectHumanspt_PT
dc.subjectFollow-Up Studiespt_PT
dc.subjectMiddle Agedpt_PT
dc.subjectGlomerular Filtration Ratept_PT
dc.subjectGlomerulonephritis / etiologypt_PT
dc.subjectGlomerulonephritis / pathologypt_PT
dc.subjectGlomerulonephritis / therapypt_PT
dc.subjectGraft Rejection / etiologypt_PT
dc.subjectGraft Rejection / pathologypt_PT
dc.subjectGraft Rejection / therapypt_PT
dc.subjectGraft Survivalpt_PT
dc.subjectIsoantibodies / bloodpt_PT
dc.subjectIsoantibodies / immunologypt_PT
dc.subjectKidney Failure, Chronic / surgerypt_PT
dc.subjectKidney Function Testspt_PT
dc.subjectKidney Glomerulus / pathologypt_PT
dc.subjectKidney Transplantation / adverse effectspt_PT
dc.subjectPostoperative Complicationspt_PT
dc.subjectPrognosispt_PT
dc.subjectRisk Factorspt_PT
dc.subjectRetrospective Studiespt_PT
dc.titleMorphologic Patterns and Treatment of Transplant Glomerulopathy: a Retrospective Analysispt_PT
dc.typejournal article
dspace.entity.typePublication
oaire.citation.startPagee12915pt_PT
oaire.citation.titleClinical Transplantationpt_PT
oaire.citation.volume31pt_PT
rcaap.rightsopenAccesspt_PT
rcaap.typearticlept_PT

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