Subclinical rejection in tacrolimus-treated renal transplant recipients

James M. Gloor, Ari J. Cohen, Donna J. Lager, Joseph Peter Grande, Mary E. Fidler, Jorge A. Velosa, Timothy S. Larson, Thomas R. Schwab, Matthew D. Griffin, Mikel Prieto, Scott Nyberg, Sylvester Sterioff, Walter K Kremers, Mark D Stegall

Research output: Contribution to journalArticle

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Abstract

Background. Subclinical rejection, defined as histologic acute rejection in the absence of graft dysfunction, has been suggested as a cause of chronic allograft rejection. In cyclosporine-treated patients, the incidence of subclinical rejection 3 months after transplant is reported to be approximately 30%. The intent of our study was to determine the incidence of subclinical rejection in tacrolimus-treated renal allograft recipients. Methods. We prospectively studied the incidence of subclinical rejection on surveillance biopsies performed 3 months after transplantation in 114 patients transplanted between September 1, 1998 and November 30, 2000. All patients received tacrolimus, mycophenolate mofetil, and prednisone, and 56% received antibody induction. Results. Subclinical rejection was detected in 2.6% of patients (3/114, 95% confidence interval 0.5-7.5%). Borderline changes were detected in 11% (12/114). Subclinical rejections were treated with bolus methylprednisolone. Conclusions. The incidence of subclinical rejection early after kidney transplantation is extremely low in tacrolimus-treated patients in whom early rejections are aggressively treated, suggesting that surveillance biopsies may not be necessary with this regimen.

Original languageEnglish (US)
Pages (from-to)1965-1968
Number of pages4
JournalTransplantation
Volume73
Issue number12
StatePublished - Jun 27 2002

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Tacrolimus
Kidney
Incidence
Allografts
Mycophenolic Acid
Transplants
Biopsy
Methylprednisolone
Prednisone
Kidney Transplantation
Cyclosporine
Transplantation
Transplant Recipients
Confidence Intervals
Antibodies

ASJC Scopus subject areas

  • Transplantation
  • Immunology

Cite this

Gloor, J. M., Cohen, A. J., Lager, D. J., Grande, J. P., Fidler, M. E., Velosa, J. A., ... Stegall, M. D. (2002). Subclinical rejection in tacrolimus-treated renal transplant recipients. Transplantation, 73(12), 1965-1968.

Subclinical rejection in tacrolimus-treated renal transplant recipients. / Gloor, James M.; Cohen, Ari J.; Lager, Donna J.; Grande, Joseph Peter; Fidler, Mary E.; Velosa, Jorge A.; Larson, Timothy S.; Schwab, Thomas R.; Griffin, Matthew D.; Prieto, Mikel; Nyberg, Scott; Sterioff, Sylvester; Kremers, Walter K; Stegall, Mark D.

In: Transplantation, Vol. 73, No. 12, 27.06.2002, p. 1965-1968.

Research output: Contribution to journalArticle

Gloor, JM, Cohen, AJ, Lager, DJ, Grande, JP, Fidler, ME, Velosa, JA, Larson, TS, Schwab, TR, Griffin, MD, Prieto, M, Nyberg, S, Sterioff, S, Kremers, WK & Stegall, MD 2002, 'Subclinical rejection in tacrolimus-treated renal transplant recipients', Transplantation, vol. 73, no. 12, pp. 1965-1968.
Gloor JM, Cohen AJ, Lager DJ, Grande JP, Fidler ME, Velosa JA et al. Subclinical rejection in tacrolimus-treated renal transplant recipients. Transplantation. 2002 Jun 27;73(12):1965-1968.
Gloor, James M. ; Cohen, Ari J. ; Lager, Donna J. ; Grande, Joseph Peter ; Fidler, Mary E. ; Velosa, Jorge A. ; Larson, Timothy S. ; Schwab, Thomas R. ; Griffin, Matthew D. ; Prieto, Mikel ; Nyberg, Scott ; Sterioff, Sylvester ; Kremers, Walter K ; Stegall, Mark D. / Subclinical rejection in tacrolimus-treated renal transplant recipients. In: Transplantation. 2002 ; Vol. 73, No. 12. pp. 1965-1968.
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abstract = "Background. Subclinical rejection, defined as histologic acute rejection in the absence of graft dysfunction, has been suggested as a cause of chronic allograft rejection. In cyclosporine-treated patients, the incidence of subclinical rejection 3 months after transplant is reported to be approximately 30{\%}. The intent of our study was to determine the incidence of subclinical rejection in tacrolimus-treated renal allograft recipients. Methods. We prospectively studied the incidence of subclinical rejection on surveillance biopsies performed 3 months after transplantation in 114 patients transplanted between September 1, 1998 and November 30, 2000. All patients received tacrolimus, mycophenolate mofetil, and prednisone, and 56{\%} received antibody induction. Results. Subclinical rejection was detected in 2.6{\%} of patients (3/114, 95{\%} confidence interval 0.5-7.5{\%}). Borderline changes were detected in 11{\%} (12/114). Subclinical rejections were treated with bolus methylprednisolone. Conclusions. The incidence of subclinical rejection early after kidney transplantation is extremely low in tacrolimus-treated patients in whom early rejections are aggressively treated, suggesting that surveillance biopsies may not be necessary with this regimen.",
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AU - Larson, Timothy S.

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N2 - Background. Subclinical rejection, defined as histologic acute rejection in the absence of graft dysfunction, has been suggested as a cause of chronic allograft rejection. In cyclosporine-treated patients, the incidence of subclinical rejection 3 months after transplant is reported to be approximately 30%. The intent of our study was to determine the incidence of subclinical rejection in tacrolimus-treated renal allograft recipients. Methods. We prospectively studied the incidence of subclinical rejection on surveillance biopsies performed 3 months after transplantation in 114 patients transplanted between September 1, 1998 and November 30, 2000. All patients received tacrolimus, mycophenolate mofetil, and prednisone, and 56% received antibody induction. Results. Subclinical rejection was detected in 2.6% of patients (3/114, 95% confidence interval 0.5-7.5%). Borderline changes were detected in 11% (12/114). Subclinical rejections were treated with bolus methylprednisolone. Conclusions. The incidence of subclinical rejection early after kidney transplantation is extremely low in tacrolimus-treated patients in whom early rejections are aggressively treated, suggesting that surveillance biopsies may not be necessary with this regimen.

AB - Background. Subclinical rejection, defined as histologic acute rejection in the absence of graft dysfunction, has been suggested as a cause of chronic allograft rejection. In cyclosporine-treated patients, the incidence of subclinical rejection 3 months after transplant is reported to be approximately 30%. The intent of our study was to determine the incidence of subclinical rejection in tacrolimus-treated renal allograft recipients. Methods. We prospectively studied the incidence of subclinical rejection on surveillance biopsies performed 3 months after transplantation in 114 patients transplanted between September 1, 1998 and November 30, 2000. All patients received tacrolimus, mycophenolate mofetil, and prednisone, and 56% received antibody induction. Results. Subclinical rejection was detected in 2.6% of patients (3/114, 95% confidence interval 0.5-7.5%). Borderline changes were detected in 11% (12/114). Subclinical rejections were treated with bolus methylprednisolone. Conclusions. The incidence of subclinical rejection early after kidney transplantation is extremely low in tacrolimus-treated patients in whom early rejections are aggressively treated, suggesting that surveillance biopsies may not be necessary with this regimen.

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