title: Evaluation of Microvascular Inflammation in ABO-Incompatible Kidney Transplantation.
abstract: In ABO-incompatible kidney transplantation, the diagnostic criteria for antibody-mediated rejection remain controversial because C4d deposition is commonly observed. Thus, we investigated microvascular inflammation (MVI score ≥ 2) within 1 year as a predictor of graft outcome.
  
  
  
  A total of 148 recipients without preformed or de novo donor-specific anti-HLA antibody were stratified based on MVI score less than 2 (n = 117) and MVI score of 2 or greater (n = 31).
  
  
  
  We found that 5-year graft survival was significantly lower (P = 0.0129) in patients with MVI (89.8%) than in patients without MVI (97.0%). Graft function, as characterized by serum estimated glomerular filtration rate, was also significantly worse for patients with MVI than it was for patients without MVI, between 3 months and 10 years after transplantation (P = 0.048). Multivariate analysis indicated that HLA class II mismatch (P = 0.0085) was an independent marker of MVI.
  
  
  
  Microvascular inflammation score of 2 or greater is significantly associated with poor graft outcome after ABO-incompatible kidney transplantation. We suggest that MVI score of 2 or greater in ABOi transplantation be used as a basis to diagnose antibody-mediated rejection.
authors: 1 Department of Urology, Kidney Center, Tokyo Women's Medical University, Shinjuku-ku, Tokyo, Japan. 2 Department of Nephrology, Kidney Center, Tokyo Women's Medical University, Shinjuku-ku, Tokyo, Japan.
authors: Hiroki
authors: H
authors: Ishihara
authors: Hideki
authors: H
authors: Ishida
authors: Kohei
authors: K
authors: Unagami
authors: Toshihito
authors: T
authors: Hirai
authors: Masayoshi
authors: M
authors: Okumi
authors: Kazuya
authors: K
authors: Omoto
authors: Tomokazu
authors: T
authors: Shimizu
authors: Kazunari
authors: K
authors: Tanabe
mesh_terms: D000017:ABO Blood-Group System / Q000276:immunology*; D000328:Adult; D001787:Blood Group Incompatibility / Q000276:immunology*; D005260:Female; D005919:Glomerular Filtration Rate; D006084:Graft Rejection / Q000276:immunology / Q000473:pathology* / Q000503:physiopathology; D006085:Graft Survival; D006648:Histocompatibility; D006801:Humans; D007668:Kidney / Q000098:blood supply* / Q000503:physiopathology; D016030:Kidney Transplantation / Q000009:adverse effects*; D008297:Male; D055806:Microvessels / Q000276:immunology / Q000473:pathology*; D008875:Middle Aged; D011237:Predictive Value of Tests; D012189:Retrospective Studies; D018570:Risk Assessment; D012307:Risk Factors; D013997:Time Factors; D016896:Treatment Outcome; D014657:Vasculitis / Q000276:immunology / Q000473:pathology*
chemical_list: D000017:ABO Blood-Group System