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.jpg): Failed to open stream: No such file or directory in C:\Inetpub\vhosts\kidney.de\httpdocs\pget.php on line 117 J+Am+Soc+Nephrol
2016 ; 27
(7
): 2188-95
Nephropedia Template TP
gab.com Text
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Tubuloreticular Inclusions in Renal Allografts Associate with Viral Infections
and Donor-Specific Antibodies
#MMPMID26614383
Willicombe M
; Moss J
; Moran L
; Brookes P
; Santos-Nunez E
; McLean AG
; Cairns T
; Taube D
; Cook TH
; Roufosse C
J Am Soc Nephrol
2016[Jul]; 27
(7
): 2188-95
PMID26614383
show ga
The presence of tubuloreticular inclusions (TRIs) in native glomerular
endothelial cells associates with viral infections and lupus nephritis. However,
the associations of TRIs in renal transplant biopsy specimens are not known. We
analyzed data from 316 patients who had a transplant biopsy with electron
microscopy examination; 41 of 316 (13.0%) patients had TRIs. Patients with TRIs
had significantly lower allograft survival rates (50.9%) than patients without
TRIs (74.3%; P=0.03). Transplant glomerulopathy-free survival was also inferior
in the TRI-positive group (57.5%) compared with the TRI-negative group (87.3%;
P=0.002). Serologically, hepatitis C associated with the presence of TRIs
(P=0.04) along with donor-specific antibodies (P=0.01). Furthermore, patients who
were TRI positive were more likely than patients who were TRI negative to have
had a previous rejection episode (P=0.02). On multivariate analysis, TRIs
associated with prior rejection, viral infections, and class 1 HLA donor-specific
antibodies. These results show that the presence of TRIs in renal allograft
biopsy specimens associates with poor allograft outcomes and serologic evidence
of viral infections and alloimmunity. The association with alloimmunity is a
novel finding that warrants additional investigation.