サクラバヤシ　ケイ   Sakurabayashi Kei
  櫻林　啓
   所属   東邦大学  医学部 医学科（大森病院）
   職種   助教
論文種別 原著
言語種別 英語
査読の有無 査読あり
表題 Effects of antirejection therapies for early subclinical acute rejection in renal transplant protocol biopsies
掲載誌名 正式名：renal replacement therapy
掲載区分国外
総ページ数 8
著者・共著者 Kei Sakurabayashi, Masaki Muramatsu, Yoshihiro Itabashi, Hideyo Oguchi, Takeshi Kawamura, Yuko Hamasaki, Tetsuo Mikami, Naobumi Tochigi, Seiichiro Shishido and Ken Sakai
担当区分 筆頭著者
発行年月 2022/04/28
概要 Abstract
Background: Although recently strengthened immunosuppression protocols have decreased the incidence of
clinical acute rejection of renal transplants, subclinical acute rejection and borderline changes remain problematic.
This study was performed to evaluate the efects of antirejection therapies for early subclinical acute rejection and
borderline changes.
Methods: In total, 269 renal transplant patients who received 3-month and 1-year protocol biopsies after renal transplantation were enrolled this study and divided into those with normal fndings (Group A) and those with ≥borderline changes (Group B) according to the 3-month pathological results. Pathological changes, graft function, and graft
survival were evaluated at 1 year.
Results: The 3-month protocol biopsy revealed normal fndings in 166 patients (Group A) and borderline changes
and subclinical acute rejection in 103 patients (Group B). In Group A, 65.1% (n=108) of the patients maintained
normal fndings at 1 year, while 30.1% (n=50) deteriorated to ≥borderline changes. In Group B, 52.4% (n=54) of
patients improved to normal. Among patients with subclinical acute rejection, 25.0% (n=5) maintained subclinical
acute rejection at 1 year despite antirejection therapy. The mean estimated glomerular fltration rate decreased from
60.4±24.5 to 58.3±19.0 mL/min/1.73 m2
in Group A and from 57.2±28.2 to 53.7±20.3 mL/min/1.73 m2
in Group B
(p=0.417). The 3-, 5-, and 7-year graft survival rates were 99.4%, 99.4%, and 97.6% in Group A and 100.0%, 98.6%, and
98.6% in Group B, respectively (p=0.709).
Conclusions: Subclinical acute rejection is likely to recur. However, intervention for subclinical acute rejection in the
early period after transplantation may help to prevent subsequent histological changes.
researchmap用URL https://rrtjournal.biomedcentral.com/counter/pdf/10.1186/s41100-022-00407-6.pdf