Ten-year protocol biopsy findings of renal allografts in the calcineurin inhibitor era.
Ten-year protocol biopsies were performed in 16 patients treated with calcineurin inhibitor (CNI) continuously. All kidney grafts were functioning well at the time of biopsy with the mean serum creatinine level of 1.6 +/- 0.8 mg/dL. The specimen of biopsy showed various degrees of tissue injury. According to the Banff grading, allograft glomerulopathy (cg) was observed in one case. Interstitial fibrosis (ci) and tubular atrophy (ct) were observed more frequently in 13 (81%) and 15 (93%) cases, respectively. Fibrous intimal thickening (cv) was seen in one (7%) case. Arteriolar hyaline thickening (ah) was seen in 14 (87%) cases. These findings were associated with chronic rejection in one case, recurrence of original disease in four (25%) cases, toxicity of CNI in 14 (87%) cases. Longer follow-up studies are needed to confirm whether CNI should be continued or not in the long-term period following kidney transplantation for better graft survival.
Okamoto
Masahiko
M
Department of Organ Interaction Research Medicine, Graduate School of Medical Science, Kyoto Prefectural University of Medicine, Kyoto, Japan. amoto@koto.kpu-m.ac.jp
Akioka
Kiyokazu
K
Ushigome
Hidetaka
H
Higuchi
Atsushi
A
Nobori
Shuji
S
Ogino
Shiro
S
Uryuhara
Kenji
K
Kaihara
Satoshi
S
Hatta
Tsuguru
T
Urasaki
Koji
K
Yoshimura
Norio
N
D000328:Adult; D001706:Biopsy; D065095:Calcineurin Inhibitors; D016572:Cyclosporine / Q000009:adverse effects / Q000276:immunology; D005500:Follow-Up Studies; D006084:Graft Rejection / Q000473:pathology; D006085:Graft Survival / Q000187:drug effects*; D006651:Histocytochemistry; D006801:Humans; D007166:Immunosuppressive Agents / Q000009:adverse effects* / Q000276:immunology; D007668:Kidney / Q000187:drug effects / Q000473:pathology*; D016030:Kidney Transplantation / Q000276:immunology / Q000473:pathology*; D016559:Tacrolimus / Q000009:adverse effects / Q000276:immunology
D065095:Calcineurin Inhibitors; D007166:Immunosuppressive Agents; D016572:Cyclosporine; D016559:Tacrolimus