Abstract: TH-PO1007

Clinical and Histologic Review of Transplant Nephrectomy Cases in a Single Center

Session Information

Category: Transplantation

  • 1702 Transplantation: Clinical and Translational

Authors

  • Bae, Soo Ya, Asan Medical Center , Seoul, Korea (the Republic of)
  • Baek, Chung Hee, Asan Medical Center, Songpa-gu, SEoul, Korea (the Republic of)
  • Park, Su-Kil, Asan Medical Center, Songpa-gu, SEoul, Korea (the Republic of)
Background

Despite advancement in the management of kidney allograft, several indications for transplant nephrectomy still exists. Chronic allograft intolerance syndrome is the most common reason of transplant nephrectomy (TN). Recent studies reported antibody mediated rejection (ABMR) plays an important role in chronic allograft injury and subsequent graft failure. There is few studies about histopathology of TN, resulting lack of knowledge about predominant type of rejection resulting chronic allograft intolerance syndrome. We investigated clinical indications and histologic diagnosis of TN cases, especially the type of rejection.

Methods

From January 1995 to March 2016, 96 cases of TN were done in Asan Medical Center. We reviewed 88 cases of TN for baseline clinical characteristics, clinical indication of TN and histologic diagnosis after TN.

Results

Most common cause of end stage renal disease (ESRD) were primary glomerular nephritis (23.9 %) and hypertension (23.9 %). Most common clinical indication of TN was chronic allograft intolerance syndrome (43.3%).
Rejection was the most common histologic diagnosis of TN (73.1%), of chronic allograft intolerance syndrome cases either (92.1%). Among 24 rejection cases diagnosed by Banff 2007, 13 cases were T cell mediated rejection (TCMR), and 10 cases were mixed rejection. Among 10 rejection cases by Banff 2013, 2 cases were TCMR, and 8 cases were mixed rejection. Among 14 cases of chronic allograft intolerance syndrome by Banff 2007 and 2013 classifications, 6 cases were TCMR, and 8 cases were mixed rejection.
9 cases showed discrepancies between clinical indication and histologic diagnosis (10.2 %), 7 cases showed discrepancies in the type of rejection (8.0 %).

Conclusion

Chronic allograft intolerance syndrome was the leading clinical indication for TN, and rejection was the most common histologic diagnosis. By Banff 2007 and 2013 classification, pure TCMR and mixed rejection cases were predominant. Some discrepancies between clinical indication and histologic diagnosis existed, with discrepancies in the type of rejection as well.