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Serial protocol biopsies to quantify the progression of chronic transplant nephropathy in stable renal allografts.
- Source :
-
American journal of transplantation : official journal of the American Society of Transplantation and the American Society of Transplant Surgeons [Am J Transplant] 2001 May; Vol. 1 (1), pp. 82-8. - Publication Year :
- 2001
-
Abstract
- Aim: To evaluate the utility of intimal thickness and interstitial width as a primary efficacy variable in the design of clinical trials aimed to modify the natural history of chronic allograft nephropathy.<br />Methods: A donor and a 4-month protocol biopsy were evaluated in 40 stable grafts according to the Banff schema. In 27 patients, a second protocol biopsy was done at 1 yr. Arterial intimal volume fraction (Vvintima/artery) and cortical interstitial volume fraction (Vvinterstitium/cortex) were estimated with a point counting technique.<br />Results: Chronic Banff scores increased during follow-up, while acute scores reached its peak at 4 months. Vvintima/artery and Vvinterstitium/cortex significantly increased at 4 months, but not at 1 yr. Vvintima/artery at 4 months correlated with donor Vvintima/artery (r = 0.57, p < 0.001), histocompatibility (r = 0.38, p = 0.01) and serum cholesterol (r = 0.31, p = 0.047). Vvinterstitium/cortex at 4 months correlated with recipient body surface area (r = 0.44, p = 0.004) and delayed graft function (p = 0.016). Power calculations showed that Vvintima/artery and Vvinterstitium/cortex allow an important reduction in minimum sample size of a hypothetical trial aimed to prevent chronic allograft nephropathy.<br />Conclusions: Intimal thickening and interstitial widening progresses rapidly during the first 4 months after transplantation and slowly thereafter. These parameters can be considered as a primary efficacy variable in trials aimed to prevent chronic allograft nephropathy.
- Subjects :
- Adolescent
Adult
Biomarkers blood
Creatinine blood
Disease Progression
Female
Graft Survival physiology
Humans
Male
Middle Aged
Monitoring, Physiologic
Renal Circulation physiology
Retrospective Studies
Time Factors
Transplantation, Homologous
Tunica Intima pathology
Biopsy methods
Kidney Transplantation pathology
Subjects
Details
- Language :
- English
- ISSN :
- 1600-6135
- Volume :
- 1
- Issue :
- 1
- Database :
- MEDLINE
- Journal :
- American journal of transplantation : official journal of the American Society of Transplantation and the American Society of Transplant Surgeons
- Publication Type :
- Academic Journal
- Accession number :
- 12095044
- Full Text :
- https://doi.org/10.1034/j.1600-6143.2001.010115.x