Overlapping pathways to transplant glomerulopathy: chronic humoral rejection, hepatitis C infection, and thrombotic microangiopathy.

Détails

ID Serval
serval:BIB_D580FFAD406F
Type
Article: article d'un périodique ou d'un magazine.
Collection
Publications
Titre
Overlapping pathways to transplant glomerulopathy: chronic humoral rejection, hepatitis C infection, and thrombotic microangiopathy.
Périodique
Kidney International
Auteur(s)
Baid-Agrawal S., Farris A.B., Pascual M., Mauiyyedi S., Farrell M.L., Tolkoff-Rubin N., Collins A.B., Frei U., Colvin R.B.
ISSN
1523-1755 (Electronic)
ISSN-L
0085-2538
Statut éditorial
Publié
Date de publication
2011
Volume
80
Numéro
8
Pages
879-885
Langue
anglais
Résumé
Transplant glomerulopathy (TG) has received much attention in recent years as a symptom of chronic humoral rejection; however, many cases lack C4d deposition and/or circulating donor-specific antibodies (DSAs). To determine the contribution of other causes, we studied 209 consecutive renal allograft indication biopsies for chronic allograft dysfunction, of which 25 met the pathological criteria of TG. Three partially overlapping etiologies accounted for 21 (84%) cases: C4d-positive (48%), hepatitis C-positive (36%), and thrombotic microangiopathy (TMA)-positive (32%) TG. The majority of patients with confirmed TMA were also hepatitis C positive, and the majority of hepatitis C-positive patients had TMA. DSAs were significantly associated with C4d-positive but not with hepatitis C-positive TG. The prevalence of hepatitis C was significantly higher in the TG group than in 29 control patients. Within the TG cohort, those who were hepatitis C-positive developed allograft failure significantly earlier than hepatitis C-negative patients. Thus, TG is not a specific diagnosis but a pattern of pathological injury involving three major overlapping pathways. It is important to distinguish these mechanisms, as they may have different prognostic and therapeutic implications.
Pubmed
Web of science
Open Access
Oui
Création de la notice
21/10/2011 10:09
Dernière modification de la notice
20/08/2019 15:55
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