1. Magnetic Resonance Elastography as Surrogate Marker of Interstitial Fibrosis in Kidney Transplantation: A Prospective Study
- Author
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Bertrand Chauveau, Pierre Merville, Bruno Soulabaille, Benjamin Taton, Hannah Kaminski, Jonathan Visentin, Agathe Vermorel, Mounir Bouzgarrou, Lionel Couzi, and Nicolas Grenier
- Subjects
General Medicine ,Original Investigation - Abstract
BACKGROUND: Fibrosis progression is a major prognosis factor in kidney transplantation. Its assessment requires an allograft biopsy, which remains an invasive procedure at risk of complications. METHODS: We assessed renal stiffness by magnetic resonance elastography (MRE) as a surrogate marker of fibrosis in a prospective cohort of kidney transplant recipients compared with the histologic gold standard. Interstitial fibrosis was evaluated by three methods: the semi-quantitative Banff ci score, a visual quantitative evaluation by a pathologist, and a computer-assisted quantitative evaluation. MRE-derived stiffness was assessed at the superior, median, and inferior poles of the allograft. RESULTS: We initially enrolled 73 patients, but only 55 had measurements of their allograft stiffness by MRE before an allograft biopsy. There was no significant correlation between MRE-derived stiffness at the biopsy site and the ci score (ρ=–0.25, P=0.06) or with the two quantitative assessments (pathologist: ρ=–0.25, P=0.07; computer assisted: ρ=–0.21, P=0.12). We observed negative correlations between the stiffness of both the biopsy site and the whole allograft, with either the glomerulosclerosis percentage (ρ=–0.32, P=0.02 and ρ=–0.31, P=0.02, respectively) and the overall nephron fibrosis percentage, defined as the mean of the percentages of glomerulosclerosis and interstitial fibrosis (ρ=–0.30, P=0.02 and ρ=–0.28, P=0.04, respectively). At patient level, mean MRE-derived stiffness was similar across the three poles of the allograft (±0.25 kPa). However, a high variability of mean stiffness was found between patients, suggesting a strong influence of confounding factors. Finally, no significant correlation was found between mean MRE-derived stiffness and the slope of eGFR (P=0.08). CONCLUSIONS: MRE-derived stiffness does not directly reflect the extent of fibrosis in kidney transplantation.
- Published
- 2022