The significance of subclinical rejection.
Subclinical rejection (SCR) is quite common early following renal transplantation and decreases progressively with time. The immunological profile of the recipient, the immunosuppressive regimen used, and the occurrence of prior episodes of clinical acute rejection (AR) are all risk factors for SCR. SCR, in turn, is a risk factor for chronic interstitial and tubular fibrosis and has been associated with worse glomerular filtration rate (GFR) and graft survival. Early SCR should be initially treated with pulse steroids. SCR is a form of biopsy-proven AR and, particularly if treated, must be fairly reported and displayed as a solid endpoint in clinical studies.
El-Amm
Jose-Marie
JM
Nazih Zuhdi Transplant Institute, Baptist Medical Center, Oklahoma City, OK 73112, USA. jose-marie.el-amm@integrisok.com
Gruber
Scott A
SA
D000208:Acute Disease; D005919:Glomerular Filtration Rate; D005938:Glucocorticoids / Q000008:administration & dosage; D006084:Graft Rejection / Q000175:diagnosis / Q000188:drug therapy / Q000276:immunology*; D006801:Humans; D016030:Kidney Transplantation / Q000276:immunology*; D020551:Pulse Therapy, Drug; D012307:Risk Factors
D005938:Glucocorticoids