ArticleJournal of the American Society of Nephrology : JASN2015
Reassessing the Significance of Intimal Arteritis in Kidney Transplant Biopsy Specimens.
Article in Journal of the American Society of Nephrology : JASN, 2015. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 16 papers.
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Who cites it
16 citing papers in PubMed.
- Defining Relationships Among Tests for Kidney Transplant Antibody-Mediated Rejection.Kidney international reports · 2025Article
- Limitations of biopsy-based transcript diagnostics to detect T-cell-mediated allograft rejection.Nephrology, dialysis, transplantation : official publication of the European Dialysis and Transplant Association - European Renal Association · 2025Article
- From Banff 1991 to Today: The Changing Landscape of the v-Lesion in Kidney Transplant Rejection.Transplant international : official journal of the European Society for Organ Transplantation · 2025Review
- Precision diagnostics in transplanted organs using microarray-assessed gene expression: concepts and technical methods of the Molecular Microscope® Diagnostic System (MMDx).Clinical science (London, England : 1979) · 2024Review
- Evolution of human kidney allograft pathology diagnostics through 30 years of the Banff classification process.World journal of transplantation · 2023Review
- The Clinical and Pathologic Phenotype of Antibody-Mediated Vascular Rejection Diagnosed Using Arterial C4d Immunoperoxidase.Kidney international reports · 2022Article
- Rejection-associated Phenotype of De Novo Thrombotic Microangiopathy Represents a Risk for Premature Graft Loss.Transplantation direct · 2021Article
- Intimal Arteritis and Microvascular Inflammation Are Associated With Inferior Kidney Graft Outcome, Regardless of Donor-Specific Antibodies.Frontiers in medicine · 2021Article
- PSMP Is Discriminative for Chronic Active Antibody-Mediated Rejection and Associate With Intimal Arteritis in Kidney Transplantation.Frontiers in immunology · 2021Article
- Early isolated V-lesion may not truly represent rejection of the kidney allograft.Clinical science (London, England : 1979) · 2018Observational
- Assessing rejection-related disease in kidney transplant biopsies based on archetypal analysis of molecular phenotypes.JCI insight · 2017Article
- Acute Rejection Phenotypes in the Current Era of Immunosuppression: A Single-Center Analysis.Transplantation direct · 2017Article
- Moving Biomarkers toward Clinical Implementation in Kidney Transplantation.Journal of the American Society of Nephrology : JASN · 2017Review
- Molecular assessment of disease states in kidney transplant biopsy samples.Nature reviews. Nephrology · 2016Review
- Early Posttransplant Isolated v1 Lesion Does Not Need to Be Treated and Does Not Lead to Increased Fibrosis.Case reports in transplantation · 2016Article
- Isolated Vascular Lesions (IVL) in Early Allograft Biopsies: A Case Series.Indian journal of nephrologyArticle
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Authors and funding
4 authors.
Funding
No grant is acknowledged in the PubMed record.
Abstract
Intimal arteritis (the presence of v-lesions) in kidney transplant biopsy specimens is believed to have major prognostic and diagnostic significance. We assessed the relationship of v-lesions to prognosis in 703 indication biopsy specimens and used microarray-based molecular tests to re-examine the relationship of v-lesions to rejection. v-Lesions were noted in 49 specimens (7%) and were usually mild (v1). The presence of v-lesions had no effect on graft survival compared with the absence of v-lesions. Pathologists using current conventions almost always interpreted v-lesions as reflecting T cell-mediated rejection (TCMR), either pure or mixed with antibody-mediated rejection (ABMR). The molecular scores questioned the conventional diagnoses in 29 of 49 specimens (59%), including ten that were conventional TCMR with no molecular rejection and nine that were conventional TCMR mixed with pure ABMR molecularly. The presence of tubulointerstitial inflammation (i-t) meeting TCMR criteria allowed subclassification of v-lesion specimens into 21 i-t-v-lesion specimens and 28 isolated v-lesion specimens. Molecular TCMR scores were positive in 95% of i-t-v-lesion specimens but only 21% of isolated v-lesion specimens. Molecular ABMR scores were often positive in isolated v-lesion biopsies (46%). Time of biopsy after transplantation was critical for understanding isolated v-lesions: most early isolated v-lesion specimens had no molecular rejection and were DSA negative, whereas most isolated >1 year after transplantation had positive DSA and ABMR scores. Therefore, v-lesions in indication biopsy specimens do not affect prognosis and can reflect TCMR, ABMR, or no rejection. Time after transplantation, DSA, and accompanying inflammation provide probabilistic basis for interpreting v-lesions.
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