Total inflammation in early protocol kidney graft biopsies does not predict progression of fibrosis at one year post-transplant.
There is an uncertainty whether total inflammation in early protocol kidney graft biopsies is associated with fibrosis progression. We investigated whether total inflammation, both in fibrotic and non-fibrotic areas, at week 6 would predict fibrosis progression at one yr post-transplant.



We included 156 single adult ABO compatible kidney recipients with adequate week 6 and one yr transplant protocol biopsies (312 biopsies). Biopsies were scored according to the current Banff criteria. In addition, fibrosis and inflammation in fibrotic and non-fibrotic areas were scored in a 10-grade semi-quantitative eyeballing system from 0% to 100%.



Fibrosis increased significantly from week 6 to one yr both by the 10-grade scoring system from 0.69 ± 1.07 to 1.45 ± 1.86, (mean ± SD), p < 0.001 and by Banff interstitial fibrosis (ci) scoring 0.81 ± 0.65 to 1.13 ± 0.87, p < 0.001. The 10-grade scoring system detected a larger proportion of fibrosis progressors than the Banff scoring 40.4% vs. 35.5%, p < 0.001. No significant positive association was found between inflammation at week 6 and progression of fibrosis in either of the scoring systems.



Total inflammation in kidney transplant biopsies at week 6 did not predict progression of fibrosis at one yr post-transplant.
Department of Transplantation Medicine, Oslo University Hospital, Oslo, Norway.
Christina
C
Dörje
Department of Transplantation Medicine, Oslo University Hospital, Oslo, Norway.
Anna Varberg
AV
Reisaeter
Department of Transplantation Medicine, Oslo University Hospital, Oslo, Norway.
Dag Olav
DO
Dahle
Department of Transplantation Medicine, Oslo University Hospital, Oslo, Norway.
Geir
G
Mjøen
Department of Transplantation Medicine, Oslo University Hospital, Oslo, Norway.
Karsten
K
Midtvedt
Department of Transplantation Medicine, Oslo University Hospital, Oslo, Norway.
Hallvard
H
Holdaas
Department of Transplantation Medicine, Oslo University Hospital, Oslo, Norway.
Linda
L
Flaa-Johnsen
Department of Radiology, Oslo University Hospital, Oslo, Norway.
Trygve
T
Syversveen
Department of Transplantation Medicine, Oslo University Hospital, Oslo, Norway.
Anders
A
Hartmann
Department of Transplantation Medicine, Oslo University Hospital, Oslo, Norway.|Metabolic and Renal Research Group, UiT, The Arctic University of Norway, Tromsø, Norway.
Trond
T
Jenssen
Department of Pathology, Oslo University Hospital, Rikshospitalet, University of Oslo, Oslo, Norway.
Helge
H
Scott
Department of Pathology, Oslo University Hospital, Rikshospitalet, University of Oslo, Oslo, Norway.
Finn P
FP
Reinholt
D001706:Biopsy / Q000379:methods*; D018450:Disease Progression; D005260:Female; D005355:Fibrosis / Q000473:pathology; D005500:Follow-Up Studies; D006084:Graft Rejection / Q000473:pathology*; D006801:Humans; D007249:Inflammation / Q000473:pathology*; D007668:Kidney / Q000473:pathology*; D016030:Kidney Transplantation / Q000009:adverse effects*; D008297:Male; D008875:Middle Aged; D011184:Postoperative Period; D011237:Predictive Value of Tests; D012189:Retrospective Studies; D013997:Time Factors; D014184:Transplantation, Homologous
Banff lesions; fibrosis; inflammation; kidney transplantation; protocol biopsy