Introduction:
Transplant glomerulopathy (TG) is a histological manifestation of chronic antibody-mediated rejection, with an incidence of 4% to 20%. This study aimed to determine the incidence, risk factors, and outcomes of TG.
Methods:
This retrospective study included renal allograft recipients who underwent graft biopsies between January 2015 and May 2022. Data were collected from electronic medical records. TG and non-TG groups were compared for the variables.
Results:
A total of 148 kidney transplant recipients underwent graft biopsies according to both protocol and indication. Transplant glomerulopathy (TG) was identified in 16 (10.8%) of these biopsies, with two cases detected in protocol biopsies within the first year post-transplantation. Among the 16 TG cases, one patient (6.2%) developed TG 6 months post-surgery, two (12.5%) between 7 and 24 months, and 13 (81%) after 25 months. The median time from transplantation to TG onset was 45 months (IQR: 29-69). Several factors, including recipient and donor age, sex, relationship, cold ischemia time, delayed graft function (DGF), HLA mismatch, historical crossmatch positivity, and blood group incompatibility, did not significantly influence TG development. At the time of TG diagnosis (via biopsy), a mean serum creatinine level of 2.70±1.18 mg% was associated with poor graft outcomes during follow-up, compared to a level of 1.53±0.29 mg% (P<0.001). Graft failure occurred in 9 of 16 (56.2%) patients with TG. On average, graft loss occurred 11.57±7.3 months after TG diagnosis. Two patients experienced graft failure concurrent with TG diagnosis.
Conclusions:
Over time, the occurrence of TG showed an upward trend and was linked to reduced graft longevity. Subclinical TG can be detected through the use of protocol biopsies. At the point of TG diagnosis, higher serum creatinine levels are associated with an increased likelihood of graft failure.
This abstract was submitted for Indian Society of Organ Transplantation (ISOT-2023)
I have no potential conflict of interest to disclose.
I did not use generative AI and AI-assisted technologies in the writing process.