Am J Transplant. 2019;19(10):2855-2864.
Clinical importance of the updated Oxford classification in allograft IgA nephropathy.
제1저자 박세훈, 고현정 · 교신저자 이하정, 문경철
소속 (11)
- Department of Internal Medicine, Seoul National University Hospital, Seoul, Korea.
- Department of Biomedical Sciences, Seoul National University College of Medicine, Seoul, Korea.
- Department of Pathology, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea.
- Department of Internal Medicine, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea.
- Department of Surgery, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea.
- Kidney Research Institute, Seoul National University College of Medicine, Seoul, Korea.
- Department of Internal Medicine, Seoul National University Boramae Medical Center, Seoul, Korea.
- Department of Surgery, Seoul National University Hospital Seoul, Seoul National University College of Medicine, Seoul, Korea.
- Transplantation Research Institute Seoul, Seoul National University College of Medicine, Seoul, Korea.
- Department of Laboratory Medicine, Seoul National University Hospital, Seoul, Korea.
- Department of Pathology, Seoul National University Hospital, Seoul, Korea.
Abstract
With the recent update to the Oxford classification for allograft IgA nephropathy (IgAN), additional investigations on the clinical significance of the updated components are warranted. We performed a retrospective cohort study at two tertiary hospitals. Kidney transplant recipients diagnosed with allograft IgAN were included in the study after additional review by specialized pathologists. We applied the updated Oxford classification and determined the MEST-C scores of the patients. The main study outcome was death-censored graft failure within 10 years after the establishment of allograft IgAN diagnosis and was assessed using the Cox regression analysis. Three hundred thirty-three allograft IgAN patients were reviewed: 100 patients with confirmed native IgAN and 233 patients with other, clinical, or unknown primary causes for end-stage renal disease (ESRD). The updated Oxford classification for allograft IgAN demonstrated prognostic value for graft failure, and patients with multiple MEST-C components had worse outcomes. M, E, S, and C were significantly associated with the prognosis of recurred IgAN and T was the only independent prognostic parameter for allograft IgAN without confirmed native IgAN. Therefore, we suggest reporting MEST-C scores in allograft biopsies and careful interpretation of the results according to the primary cause of ESRD.
© 2019 The American Society of Transplantation and the American Society of Transplant Surgeons.
Keywords
clinical research/practiceglomerular biology and diseasegraft survivalkidney (allograft) function/dysfunctionkidney disease: immune/inflammatorykidney transplantation/nephrologypathology/histopathologyrecurrent disease
그 밖의 정보
- 출판 형태
- Journal Article, Research Support, Non-U.S. Gov't
- 저널
- American journal of transplantation : official journal of the American Society of Transplantation and the American Society of Transplant Surgeons · eISSN 1600-6143
- 전자 출판
- 2019-05-20
- MeSH
- Adult · Female · Follow-Up Studies · Glomerular Filtration Rate · Glomerulonephritis, IGA / classification / diagnosis / etiology · Graft Rejection / diagnosis / etiology · Graft Survival · Humans · Kidney / pathology · Kidney Failure, Chronic / pathology / surgery · Kidney Function Tests · Kidney Transplantation / adverse effects · Male · Middle Aged · Postoperative Complications / diagnosis / etiology · Prognosis · Retrospective Studies · Risk Factors · Transplantation, Homologous
- 참고문헌
- 29편