Prevalence of clinical rejection after surveillance biopsies in pediatric renal transplants: Does early subclinical rejection predispose to subsequent rejection episodes?

:  We analyzed rates of both SCR and CR in children receiving SB at three months post‐transplant to determine if SCR predisposed patients to acute CR. Acute rejection was defined according to Banff criteria to include borderline classification or higher. All cases of SCR and CR were treated with ant...

Full description

Saved in:
Bibliographic Details
Published in:Pediatric transplantation 2009-11, Vol.13 (7), p.823-826
Main Authors: Hymes, Leonard C., Warshaw, Barry L., Hennigar, Randolph A., Amaral, Sandra G., Greenbaum, Larry A.
Format: Article
Language:English
Subjects:
acute rejection
Adolescent
allograft outcomes
Biological and medical sciences
Biopsy
Child
Child, Preschool
Complement C4b - metabolism
Epidemiology
Fibrosis - pathology
Follow-Up Studies
General aspects
Graft Rejection
Humans
Immunosuppressive Agents - administration & dosage
kidney transplant
Kidney Transplantation - methods
Medical sciences
Peptide Fragments - metabolism
Prednisone - administration & dosage
Public health. Hygiene
Public health. Hygiene-occupational medicine
Surgery (general aspects). Transplantations, organ and tissue grafts. Graft diseases
Tacrolimus - administration & dosage
Transplantation, Homologous
Treatment Outcome
Citations: Items that this one cites
Items that cite this one
Online Access:Get full text
Tags: Add Tag
No Tags, Be the first to tag this record!
Description
Summary::  We analyzed rates of both SCR and CR in children receiving SB at three months post‐transplant to determine if SCR predisposed patients to acute CR. Acute rejection was defined according to Banff criteria to include borderline classification or higher. All cases of SCR and CR were treated with anti‐rejection protocols. Between October 2004 and July 2008, 89 SB were performed at three months post‐transplant. Twenty‐six cases of SCR were detected (29%). Sixteen patients experienced 22 episodes of biopsy‐proven CR occurring after SB, including seven episodes following SCR and 15 after normal SB. The onset of CR varied from one to 27 months after SB and occurred at similar intervals for cases with SCR and normal SB. The percentage of patients remaining free of CR at 30 months post‐transplant was similar in patients with SCR and normal SB. Renal function and graft survival at 30 months also were no different between patients with SCR and those with normal SB. Early‐SCR, when treated with rejection protocols, is not a prognostic indicator for subsequent CR episodes.
ISSN:1397-3142
1399-3046
DOI:10.1111/j.1399-3046.2009.01200.x