title: Renal allograft biopsies with borderline changes: predictive factors of clinical outcome.
abstract: The clinical outcome and appropriate management for patients showing 'borderline changes' on allograft biopsy after renal transplantation is still controversial. In an attempt to identify predictive factors of clinical outcome of patients with such lesions, we reviewed the clinical course of 91 patients with borderline changes. Multivariate analysis revealed significant and independent effects of histological stage (i + t < or = or > 2) and time to borderline changes (< or = or > 3 months after transplant) on serum creatinine levels at 1 year from borderline changes episodes (respectively, p = 0.04 and p = 0.02) and only a significant effect of time to borderline changes on serum creatinine levels at 2 years (p = 0.005). Renal function at 1 year and 2 years as 5- and 8-year graft survival were not significantly different in the group of patients treated with antirejection therapy (T group, n = 49) compared with the untreated group (UT group, n = 42). This study strongly suggests that borderline changes with histological score (i + t) > 2 and late episodes of borderline changes should be considered to be of poor prognosis.
authors.affiliation: Department of Nephrology and Renal Transplantation, Hopital Henri Mondor and Universite Paris XII, Creteil, France.
authors.forename: K
authors.initials: K
authors.lastname: Dahan
authors.forename: V
authors.initials: V
authors.lastname: Audard
authors.forename: F
authors.initials: F
authors.lastname: Roudot-Thoraval
authors.forename: D
authors.initials: D
authors.lastname: Desvaux
authors.forename: M
authors.initials: M
authors.lastname: Abtahi
authors.forename: H
authors.initials: H
authors.lastname: Mansour
authors.forename: M
authors.initials: M
authors.lastname: Kumal
authors.forename: P
authors.initials: P
authors.lastname: Lang
authors.forename: P
authors.initials: P
authors.lastname: Grimbert
mesh_terms: D000328:Adult; D001706:Biopsy; D003401:Creatine / Q000097:blood; D005260:Female; D005500:Follow-Up Studies; D006085:Graft Survival / Q000187:drug effects; D006801:Humans; D007166:Immunosuppressive Agents / Q000494:pharmacology; D007668:Kidney / Q000473:pathology* / Q000601:surgery*; D016030:Kidney Transplantation / Q000473:pathology*; D008297:Male; D008875:Middle Aged; D014184:Transplantation, Homologous / Q000473:pathology; D016896:Treatment Outcome
chemical_list: D007166:Immunosuppressive Agents; D003401:Creatine