Long-term Impact of Subclinical Inflammation Diagnosed by Protocol Biopsy One Year After Renal Transplantation.

Antoine Thierry; Eric Thervet; Vincent Vuiblet; Jean-Michel Goujon; Marie-Christine Machet; Laure-Hélène Noël; Nathalie Rioux-Leclercq; François Comoz; Carole Cordonnier; Arnaud François; Luc Marcellin; Sandrine Girardot-Seguin; Guy Touchard

doi:10.1111/j.1600-6143.2011.03695.x

Journal articles

Long-term Impact of Subclinical Inflammation Diagnosed by Protocol Biopsy One Year After Renal Transplantation.

Antoine Thierry ^{1, 2, *} Eric Thervet ³ Vincent Vuiblet ⁴ Jean-Michel Goujon ^{1, 5} Marie-Christine Machet ⁶ Laure-Hélène Noël ⁷ Nathalie Rioux-Leclercq ⁸ François Comoz ⁹ Carole Cordonnier ¹⁰ Arnaud François ¹¹ Luc Marcellin ¹² Sandrine Girardot-Seguin ¹³ Guy Touchard ^{1, 2}

* Corresponding author

1 Ischémie - Reperfusion en transplatation rénale

2 Service de néphrologie - hémodialyse et transplantation rénale

3 Service de néphrologie et transplantation

4 Hôpital Maison Blanche

5 Laboratoire d'anatomopathologie

6 Service d'Anatomopathologie [Tours]

7 Service d'anatomie pathologique [CHU Necker]

8 Service d'anatomie et cytologie pathologiques [Rennes]

9 Laboratoire d'Anatomie Pathologique [CHU Caen]

10 Service d'anatomie et cytopathologie

11 Service d'Anatomie et Cytologie Pathologique [CHU Rouen]

12 Département de Pathologie

13 Laboratoire Roche

Abstract : The long-term impact of subclinical acute rejection (SCAR) on renal graft function remains poorly understood. Furthermore, the interpretation of borderline lesions is difficult and their incidence is variable. The aim of this study was to analyze the characteristics of subclinical inflammation (SCI) in protocol biopsies performed 1-year after renal transplantation. SCI was defined as the presence of borderline lesions or SCAR according to the Banff 2005 classification. The patients included were a subpopulation of the CONCEPT study in which patients were randomized 3 months after transplantation to receive either sirolimus (SRL) or cyclosporine A (CsA) in combination with mycophenolate mofetil. At 1 year, we observed SCI in 37 of the 121 patients observed with an evaluable biopsy. The incidence was more frequent in the SRL group (SRL 45.2% vs. CsA 15.3%). At 30 months , SCI was associated with a significantly lower level of estimated glomerular filtration rate (mean MDRD 50.8 [±13.3] vs. 57.7 [±16.3] mL/min/1.73 m(2) , p = 0.035). In conclusion, SCI at 1-year posttransplantation is associated with worsening renal function and is more frequent in SRL-treated patients. Therefore, evaluation of SCI may be a valuable tool to allow the optimization of immunosuppressive regimens.

Keywords : Protocol biopsy renal function renal transplantation subclinical inflammation

Document type :

Journal articles

Domain :

Life Sciences [q-bio] / Immunology

Life Sciences [q-bio] / Human health and pathology / Urology and Nephrology

Life Sciences [q-bio] / Human health and pathology / Surgery

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https://www.hal.inserm.fr/inserm-00620852
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Submitted on : Thursday, September 8, 2011 - 6:13:47 PM
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Long-term Impact of Subclinical Inflammation Diagnosed by Protocol Biopsy One Year After Renal Transplantation.

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Long-term Impact of Subclinical Inflammation Diagnosed by Protocol Biopsy One Year After Renal Transplantation.

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