Borderline Changes in Renal Allograft Protocol Biopsies: Intensive Therapy And Graft Outcome

Ji Shu-Ming; Chen Jin-Song; Wen Ji-Qiu; Cheng Dong-Rui

Volume : V, Issue : II, February - 2015

Borderline Changes in Renal Allograft Protocol Biopsies: Intensive Therapy And Graft Outcome

Ji Shu 45 Ming, Chen Jin 45 Song, Wen Ji 45 Qiu, Cheng Dong 45 Rui

Abstract :

Objective To evaluate the relationship between borderline changes and graft outcome in recipients of cadaveric kidney transplantation. | Methods All biopsies were systematically evaluated according to Banff schema. PAP four–layer immunohistochemical staining was applied in the detection of CD4+, CD8+, CD68+, CD25+ cell, PCNA infiltration and HLA–DR protein synthesis. Patients with borderline change were analyzed by “intent to treat” and were followed for a minimum of 3–year. | Results Forty–six recipients with “borderline changes” were diagnosed within 3 months after transplantation. Patients by “intent to treat”(Treated group) had a significant decrease in early acute rejection episodes and a lower serum creatinine at one month than did patients in the untreated group. In borderline changes biopsies, there were more infiltrating CD4+,CD8+,CD68+,CD25+ cells than those in normal allografts, but still significantly less than those in allografts with acute rejection. | Conclusion The results of this study suggest the early protocol biopsy and the treatment of borderline with corticosteroids may lead to better histologic and functional outcomes in renal transplant recipients.