Impact of Microvascular Inflammation on Kidney Transplant Rejection
Microvascular inflammation post-kidney transplantation is critical as it can lead to graft dysfunction and rejection. Understanding this process aids in improving patient outcomes.
A recent study has identified new rejection factors in kidney transplantation that could lead to more accurate patient risk assessment after surgery. ()
What is Kidney Transplant Rejection
Kidney transplant rejection continues to threaten the long-term success of kidney transplants, with microvascular inflammation (inflammation within capillaries) playing a pivotal role in graft failure. Due to its complex nature, this inflammation poses a major challenge in clinical practice.‘Kidney #transplantrejection is a serious concern that can occur when the body�s immune system attacks the new organ. Early detection and treatment are crucial for patient outcomes. #kidneyhealth #organdonation #mohanfoundation’
In response, the international Banff classification-the global standard for diagnosing transplant rejection-has redefined antibody-mediated rejection diagnostics by introducing two new categories of microvascular inflammation: mild microvascular inflammation with probable antibody-mediated rejection and microvascular inflammation in the absence of antibody-mediated responses.
In a landmark study analyzing more than 16,000 biopsies from almost 7,000 kidney transplant recipients, researchers found that many cases initially considered as non-rejection were reclassified into the newly defined categories of microvascular inflammation. Importantly, reclassified patients with microvascular inflammation in the absence of antibody-mediated responses displayed an increased risk of graft failure compared with those without signs of rejection, underscoring the importance of this new classification.
"Recognizing these phenotypes could improve risk stratification and support more personalized management for kidney transplant patients," explains first author, Aur�lie Sannier, pathologist and researcher at the Paris Institute for Transplantation and Organ Regeneration. "We encourage large studies in other organ transplants where microvascular inflammation is also a critical feature of antibody-mediated rejection."
Reference:
- Microvascular Inflammation of Kidney Allografts and Clinical Outcomes - (https:www.nejm.org/doi/full/10.1056/NEJMoa2408835)