Early Posttransplant Isolated v1 Lesion Does Not Need to Be Treated and Does Not Lead to Increased FibrosisReport as inadecuate




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Case Reports in Transplantation - Volume 2016 2016, Article ID 4603014, 3 pages -

Case Report

Division of Nephrology, University of Arizona, Tucson, AZ 85724, USA

Department of Pathology, University of Arizona, Tucson, AZ 85724, USA

Division of Nephrology, Southern Arizona Veterans Affairs Health Care System, Tucson, AZ 85723, USA

Received 28 January 2016; Revised 20 April 2016; Accepted 3 May 2016

Academic Editor: Marian Klinger

Copyright © 2016 Irfan Moinuddin et al. This is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

Abstract

Acute vascular rejection AVR is characterized by intimal arteritis in addition to tubulitis and interstitial inflammation. It is associated with a poorer prognosis compared to tubulointerstitial rejection AIR and AVR is associated with a higher rate of graft loss than AIR. The prognosis and treatment of arteritis without tubulitis and interstitial inflammation isolated v1 lesion are still controversial. We report a case of a patient who had a biopsy of the kidney allograft for evaluation of slow graft function. The biopsy revealed an isolated v1 lesion. However, we chose not to augment immunosuppression. The patient’s kidney allograft function improved over time with close monitoring. Repeat biopsy a year later showed no evidence of endothelialitis and relatively unchanged fibrosis and no other abnormalities. Although it is suggested that most cases of isolated v1 lesions will respond to corticosteroids or T cell depleting therapies, some cases will improve with conservative management. Further studies are needed to determine which cases could be managed conservatively.





Author: Irfan Moinuddin, Bijin Thajudeen, Amy Sussman, Machaiah Madhrira, Erika Bracamonte, Mordecai Popovtzer, and Pradeep V. Kadam

Source: https://www.hindawi.com/



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