title: Interstitial fibrosis and tubular atrophy on protocol biopsies at 1 year after renal transplantation.
abstract: BACKGROUND
  Advancements in immunosuppressive therapy have enabled control of early acute rejection and improved long-term kidney transplantation (KT) survival. Chronic histopathologic changes influence graft survival rate. We examined tubulointerstitial changes at 1 year after KT, focusing on the progression of interstitial fibrosis and/or tubular atrophy (IF/TA).
  
  
  METHODS
  Using the Banff' 07 classification, we assessed the histological findings obtained at 1 year after transplantation of 38 patients who underwent the procedure between January 2008, and March 2010. In 24 cases, we obtained scores for interstitial fibrosis (ci) >1 and/or tubular atrophy (ct) > 1. We classified the patients into two groups, namely, less than borderline changes (BCs) (t0, i0, or i1; group A) versus BCs and above (t > 1, i2, or i3; group B). We compared their baseline data, renal function, and pathological scores.
  
  
  RESULTS
  The mean serum creatinine levels were 1.06 mg/dL for group A and 1.32 mg/dL for group B. The "ct" grading according to the Banff' 07 classification was 0.83 for group A and 1.50 for group B (both P < .05). No significant difference was observed with respect to the percentage of patients with IF/TA (Banff category 5).
  
  
  CONCLUSIONS
  Patients more within 1 year after KT with BCs who show irreversible tubular atrophy by biopsy experience impaired renal function. The presence of BC at the first year may not be associated with IF/TA.
authors.affiliation: Department of Surgery, Tokyo Medical University Hachioji Medical Center, Tokyo, Japan. taka-y@air.ocn.ne.jp
authors.forename: T
authors.initials: T
authors.lastname: Yokoyama
authors.forename: O
authors.initials: O
authors.lastname: Konno
authors.forename: Y
authors.initials: Y
authors.lastname: Nakamura
authors.forename: Y
authors.initials: Y
authors.lastname: Kihara
authors.forename: Y
authors.initials: Y
authors.lastname: Jojima
authors.forename: K
authors.initials: K
authors.lastname: Hama
authors.forename: H
authors.initials: H
authors.lastname: Iwamoto
authors.forename: M
authors.initials: M
authors.lastname: Shimazu
authors.forename: M
authors.initials: M
authors.lastname: Otani
mesh_terms: D000328:Adult; D001706:Biopsy; D005260:Female; D005355:Fibrosis; D006085:Graft Survival; D006801:Humans; D016030:Kidney Transplantation; D007684:Kidney Tubules / Q000473:pathology*; D008297:Male; D008875:Middle Aged