Dörje Christina, Mjøen Geir, Strøm Erik H, Holdaas Hallvard, Jenssen Trond, Øyen Ole, Akkök Çigdem Akalin, Cvancarova Milada, Midtvedt Karsten, Reisaeter Anna Varberg
Department of Transplant Medicine, Oslo University Hospital, Rikshospitalet, Oslo, Norway.
Clin Transplant. 2015 Mar;29(3):268-76. doi: 10.1111/ctr.12515. Epub 2015 Feb 6.
Early acute antibody-mediated rejection (ABMR) occurs more frequently in ABO-incompatible (ABOi) than in ABO-compatible (ABOc) kidney transplantation. This could lead to increased inflammation/scarring in the ABOi grafts. Protocol biopsy data in ABOi kidney recipients are scarce.
A single-center retrospective matched cohort study was conducted. Eighty adult living donor (LD) renal transplant recipients without HLA donor-specific antibodies (DSA) transplanted between 2009 and 2012 were included; 20 ABOi and 60 ABOc controls matched for donor age and transplantation year. Protocol biopsies at one yr were scored according to the Banff classification. Three sums of scores were constructed: tubulointerstitial inflammation (t + i = 0 vs. >0), microvascular inflammation (g + ptc = 0 vs. >0), scarring/hyalinosis (ci + ct + cv + ah ≤ 1 vs. >1. Scores and presence of subclinical rejection (SCR) at one yr were compared.
Protocol biopsy findings at one yr in the ABOi vs. ABOc matched control group were not statistically different: (t + i) > 0, 30% vs. 20%; (g + ptc) > 0, 5% vs. 8%; (ci + ct + cv + ah) > 1, 85% vs. 60%, respectively. No transplant glomerulopathy occurred. SCR rate at one yr was 30% vs. 18%, subclinical ABMR 5% vs. 7% (all with de novo HLA DSA).
One-year protocol biopsies of ABOi and ABOc LD recipients do not differ in chronic changes, inflammation, or SCRs.
早期急性抗体介导的排斥反应（ABMR）在ABO血型不相容（ABOi）肾移植中比在ABO血型相容（ABOc）肾移植中更频繁发生。这可能导致ABOi移植物中炎症/瘢痕形成增加。ABOi肾移植受者的方案活检数据稀缺。
进行了一项单中心回顾性匹配队列研究。纳入2009年至2012年间接受移植的80名无HLA供体特异性抗体（DSA）的成年活体供肾（LD）肾移植受者；20名ABOi受者和60名ABOc对照者，根据供体年龄和移植年份进行匹配。根据Banff分类对1年时的方案活检进行评分。构建了三个评分总和：肾小管间质炎症（t + i = 0 vs. >0）、微血管炎症（g + ptc = 0 vs. >0）、瘢痕形成/透明变性（ci + ct + cv + ah ≤ 1 vs. >1）。比较了1年时的评分和亚临床排斥反应（SCR）的存在情况。
ABOi组与ABOc匹配对照组1年时的方案活检结果无统计学差异：（t + i）> 0，分别为30% vs. 20%；（g + ptc）> 0，分别为5% vs. 8%；（ci + ct + cv + ah）> 1，分别为85% vs. 60%。未发生移植肾小球病。1年时的SCR率分别为30% vs. 18%，亚临床ABMR分别为5% vs. 7%（均伴有新生HLA DSA）。
ABOi和ABOc LD受者的1年方案活检在慢性改变、炎症或SCR方面无差异。
