Graft dysfunction in simultaneous pancreas kidney transplantation (SPK): Results of concurrent kidney and pancreas allograft biopsies

Autores
Uva, Pablo Daniel; Papadimitriou, J. C.; Drachenberg, Cinthia B.; Toniolo, María F.; Quevedo, Alejandra; Dotta, A. C.; Chuluyan, Hector Eduardo; Casadei, D. H.
Año de publicación
2019
Idioma
inglés
Tipo de recurso
artículo
Estado
versión publicada
Descripción
Simultaneous pancreas and kidney transplants offer significant therapeutic advantages but present a diagnostic approach dilemma in the diagnosis of rejection. Because both organs are from the same donor, the kidney has been treated traditionally as the “sentinel” organ to biopsy, presumably representing the status of both allografts. Truly concurrent biopsy studies, however, are needed to confirm this hypothesis. We examined 101 concurrent biopsies from 70 patients with dysfunction in either or both organs. Results showed concurrent rejection in 23 of 57 (40%) of cases with rejection; 19 of 57 (33.5%) and 15 of 57 (26.5%) showed kidney or pancreas only rejection, respectively. The degree and type of rejection differed in the majority (13 of 23, 56.5%) of cases with concurrent rejection, with the pancreas more often showing higher rejection grade. Taking into account pancreas dysfunction, a positive kidney biopsy should correctly predict pancreas rejection in 86% of the instances. However, the lack of complete concordance between the 2 organs, the discrepancies in grade and type of rejection, and the tendency for higher rejection grades in concurrent or pancreas only rejections, all support the rationale for pancreas biopsies. The latter provide additional data on the overall status of the organ, as well as information on nonrejection-related pathologies.
Fil: Uva, Pablo Daniel. Consejo Nacional de Investigaciones Científicas y Técnicas. Oficina de Coordinación Administrativa Houssay. Centro de Estudios Farmacológicos y Botánicos. Universidad de Buenos Aires. Facultad de Medicina. Centro de Estudios Farmacológicos y Botánicos; Argentina. Instituto de Nefrología de Buenos Aires; Argentina
Fil: Papadimitriou, J. C.. University of Maryland; Estados Unidos
Fil: Drachenberg, Cinthia B.. University of Maryland; Estados Unidos
Fil: Toniolo, María F.. Instituto de Nefrología de Buenos Aires; Argentina
Fil: Quevedo, Alejandra. Instituto de Nefrología de Buenos Aires; Argentina
Fil: Dotta, A. C.. Instituto de Nefrología de Buenos Aires; Argentina
Fil: Chuluyan, Hector Eduardo. Consejo Nacional de Investigaciones Científicas y Técnicas. Oficina de Coordinación Administrativa Houssay. Centro de Estudios Farmacológicos y Botánicos. Universidad de Buenos Aires. Facultad de Medicina. Centro de Estudios Farmacológicos y Botánicos; Argentina
Fil: Casadei, D. H.. Instituto de Nefrología de Buenos Aires; Argentina
Materia
BIOPSY
CLINICAL RESEARCH / PRACTICE
MONITORING: IMMUNE
PANCREAS / SIMULTANEOUS PANCREAS-KIDNEY TRANSPLANTATION
REJECTION
Nivel de accesibilidad
acceso abierto
Condiciones de uso
https://creativecommons.org/licenses/by-nc-sa/2.5/ar/
Repositorio
CONICET Digital (CONICET)
Institución
Consejo Nacional de Investigaciones Científicas y Técnicas
OAI Identificador
oai:ri.conicet.gov.ar:11336/88432
Acceder
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oai_identifier_str oai:ri.conicet.gov.ar:11336/88432
network_acronym_str CONICETDig
repository_id_str 3498
network_name_str CONICET Digital (CONICET)
spelling Graft dysfunction in simultaneous pancreas kidney transplantation (SPK): Results of concurrent kidney and pancreas allograft biopsiesUva, Pablo DanielPapadimitriou, J. C.Drachenberg, Cinthia B.Toniolo, María F.Quevedo, AlejandraDotta, A. C.Chuluyan, Hector EduardoCasadei, D. H.BIOPSYCLINICAL RESEARCH / PRACTICEMONITORING: IMMUNEPANCREAS / SIMULTANEOUS PANCREAS-KIDNEY TRANSPLANTATIONREJECTIONhttps://purl.org/becyt/ford/3.2https://purl.org/becyt/ford/3Simultaneous pancreas and kidney transplants offer significant therapeutic advantages but present a diagnostic approach dilemma in the diagnosis of rejection. Because both organs are from the same donor, the kidney has been treated traditionally as the “sentinel” organ to biopsy, presumably representing the status of both allografts. Truly concurrent biopsy studies, however, are needed to confirm this hypothesis. We examined 101 concurrent biopsies from 70 patients with dysfunction in either or both organs. Results showed concurrent rejection in 23 of 57 (40%) of cases with rejection; 19 of 57 (33.5%) and 15 of 57 (26.5%) showed kidney or pancreas only rejection, respectively. The degree and type of rejection differed in the majority (13 of 23, 56.5%) of cases with concurrent rejection, with the pancreas more often showing higher rejection grade. Taking into account pancreas dysfunction, a positive kidney biopsy should correctly predict pancreas rejection in 86% of the instances. However, the lack of complete concordance between the 2 organs, the discrepancies in grade and type of rejection, and the tendency for higher rejection grades in concurrent or pancreas only rejections, all support the rationale for pancreas biopsies. The latter provide additional data on the overall status of the organ, as well as information on nonrejection-related pathologies.Fil: Uva, Pablo Daniel. Consejo Nacional de Investigaciones Científicas y Técnicas. Oficina de Coordinación Administrativa Houssay. Centro de Estudios Farmacológicos y Botánicos. Universidad de Buenos Aires. Facultad de Medicina. Centro de Estudios Farmacológicos y Botánicos; Argentina. Instituto de Nefrología de Buenos Aires; ArgentinaFil: Papadimitriou, J. C.. University of Maryland; Estados UnidosFil: Drachenberg, Cinthia B.. University of Maryland; Estados UnidosFil: Toniolo, María F.. Instituto de Nefrología de Buenos Aires; ArgentinaFil: Quevedo, Alejandra. Instituto de Nefrología de Buenos Aires; ArgentinaFil: Dotta, A. C.. Instituto de Nefrología de Buenos Aires; ArgentinaFil: Chuluyan, Hector Eduardo. Consejo Nacional de Investigaciones Científicas y Técnicas. Oficina de Coordinación Administrativa Houssay. Centro de Estudios Farmacológicos y Botánicos. Universidad de Buenos Aires. Facultad de Medicina. Centro de Estudios Farmacológicos y Botánicos; ArgentinaFil: Casadei, D. H.. Instituto de Nefrología de Buenos Aires; ArgentinaWiley Blackwell Publishing, Inc2019-02info:eu-repo/semantics/articleinfo:eu-repo/semantics/publishedVersionhttp://purl.org/coar/resource_type/c_6501info:ar-repo/semantics/articuloapplication/pdfapplication/pdfapplication/pdfapplication/pdfhttp://hdl.handle.net/11336/88432Uva, Pablo Daniel; Papadimitriou, J. C.; Drachenberg, Cinthia B.; Toniolo, María F.; Quevedo, Alejandra; et al.; Graft dysfunction in simultaneous pancreas kidney transplantation (SPK): Results of concurrent kidney and pancreas allograft biopsies; Wiley Blackwell Publishing, Inc; American Journal of Transplantation; 19; 2; 2-2019; 466-4741600-6135CONICET DigitalCONICETenginfo:eu-repo/semantics/altIdentifier/url/https://onlinelibrary.wiley.com/doi/abs/10.1111/ajt.15012info:eu-repo/semantics/altIdentifier/doi/10.1111/ajt.15012info:eu-repo/semantics/openAccesshttps://creativecommons.org/licenses/by-nc-sa/2.5/ar/reponame:CONICET Digital (CONICET)instname:Consejo Nacional de Investigaciones Científicas y Técnicas2026-08-25T14:52:54Zoai:ri.conicet.gov.ar:11336/88432instacron:CONICETInstitucionalhttp://ri.conicet.gov.ar/Organismo científico-tecnológicoNo correspondehttp://ri.conicet.gov.ar/oai/requestdasensio@conicet.gov.ar; lcarlino@conicet.gov.arArgentinaNo correspondeNo correspondeNo correspondeopendoar:34982026-08-25 14:52:55.19CONICET Digital (CONICET) - Consejo Nacional de Investigaciones Científicas y Técnicasfalse
dc.title.none.fl_str_mv Graft dysfunction in simultaneous pancreas kidney transplantation (SPK): Results of concurrent kidney and pancreas allograft biopsies
title Graft dysfunction in simultaneous pancreas kidney transplantation (SPK): Results of concurrent kidney and pancreas allograft biopsies
spellingShingle Graft dysfunction in simultaneous pancreas kidney transplantation (SPK): Results of concurrent kidney and pancreas allograft biopsies
Uva, Pablo Daniel
BIOPSY
CLINICAL RESEARCH / PRACTICE
MONITORING: IMMUNE
PANCREAS / SIMULTANEOUS PANCREAS-KIDNEY TRANSPLANTATION
REJECTION
title_short Graft dysfunction in simultaneous pancreas kidney transplantation (SPK): Results of concurrent kidney and pancreas allograft biopsies
title_full Graft dysfunction in simultaneous pancreas kidney transplantation (SPK): Results of concurrent kidney and pancreas allograft biopsies
title_fullStr Graft dysfunction in simultaneous pancreas kidney transplantation (SPK): Results of concurrent kidney and pancreas allograft biopsies
title_full_unstemmed Graft dysfunction in simultaneous pancreas kidney transplantation (SPK): Results of concurrent kidney and pancreas allograft biopsies
title_sort Graft dysfunction in simultaneous pancreas kidney transplantation (SPK): Results of concurrent kidney and pancreas allograft biopsies
dc.creator.none.fl_str_mv Uva, Pablo Daniel
Papadimitriou, J. C.
Drachenberg, Cinthia B.
Toniolo, María F.
Quevedo, Alejandra
Dotta, A. C.
Chuluyan, Hector Eduardo
Casadei, D. H.
author Uva, Pablo Daniel
author_facet Uva, Pablo Daniel
Papadimitriou, J. C.
Drachenberg, Cinthia B.
Toniolo, María F.
Quevedo, Alejandra
Dotta, A. C.
Chuluyan, Hector Eduardo
Casadei, D. H.
author_role author
author2 Papadimitriou, J. C.
Drachenberg, Cinthia B.
Toniolo, María F.
Quevedo, Alejandra
Dotta, A. C.
Chuluyan, Hector Eduardo
Casadei, D. H.
author2_role author
author
author
author
author
author
author
dc.subject.none.fl_str_mv BIOPSY
CLINICAL RESEARCH / PRACTICE
MONITORING: IMMUNE
PANCREAS / SIMULTANEOUS PANCREAS-KIDNEY TRANSPLANTATION
REJECTION
topic BIOPSY
CLINICAL RESEARCH / PRACTICE
MONITORING: IMMUNE
PANCREAS / SIMULTANEOUS PANCREAS-KIDNEY TRANSPLANTATION
REJECTION
purl_subject.fl_str_mv https://purl.org/becyt/ford/3.2
https://purl.org/becyt/ford/3
dc.description.none.fl_txt_mv Simultaneous pancreas and kidney transplants offer significant therapeutic advantages but present a diagnostic approach dilemma in the diagnosis of rejection. Because both organs are from the same donor, the kidney has been treated traditionally as the “sentinel” organ to biopsy, presumably representing the status of both allografts. Truly concurrent biopsy studies, however, are needed to confirm this hypothesis. We examined 101 concurrent biopsies from 70 patients with dysfunction in either or both organs. Results showed concurrent rejection in 23 of 57 (40%) of cases with rejection; 19 of 57 (33.5%) and 15 of 57 (26.5%) showed kidney or pancreas only rejection, respectively. The degree and type of rejection differed in the majority (13 of 23, 56.5%) of cases with concurrent rejection, with the pancreas more often showing higher rejection grade. Taking into account pancreas dysfunction, a positive kidney biopsy should correctly predict pancreas rejection in 86% of the instances. However, the lack of complete concordance between the 2 organs, the discrepancies in grade and type of rejection, and the tendency for higher rejection grades in concurrent or pancreas only rejections, all support the rationale for pancreas biopsies. The latter provide additional data on the overall status of the organ, as well as information on nonrejection-related pathologies.
Fil: Uva, Pablo Daniel. Consejo Nacional de Investigaciones Científicas y Técnicas. Oficina de Coordinación Administrativa Houssay. Centro de Estudios Farmacológicos y Botánicos. Universidad de Buenos Aires. Facultad de Medicina. Centro de Estudios Farmacológicos y Botánicos; Argentina. Instituto de Nefrología de Buenos Aires; Argentina
Fil: Papadimitriou, J. C.. University of Maryland; Estados Unidos
Fil: Drachenberg, Cinthia B.. University of Maryland; Estados Unidos
Fil: Toniolo, María F.. Instituto de Nefrología de Buenos Aires; Argentina
Fil: Quevedo, Alejandra. Instituto de Nefrología de Buenos Aires; Argentina
Fil: Dotta, A. C.. Instituto de Nefrología de Buenos Aires; Argentina
Fil: Chuluyan, Hector Eduardo. Consejo Nacional de Investigaciones Científicas y Técnicas. Oficina de Coordinación Administrativa Houssay. Centro de Estudios Farmacológicos y Botánicos. Universidad de Buenos Aires. Facultad de Medicina. Centro de Estudios Farmacológicos y Botánicos; Argentina
Fil: Casadei, D. H.. Instituto de Nefrología de Buenos Aires; Argentina
description Simultaneous pancreas and kidney transplants offer significant therapeutic advantages but present a diagnostic approach dilemma in the diagnosis of rejection. Because both organs are from the same donor, the kidney has been treated traditionally as the “sentinel” organ to biopsy, presumably representing the status of both allografts. Truly concurrent biopsy studies, however, are needed to confirm this hypothesis. We examined 101 concurrent biopsies from 70 patients with dysfunction in either or both organs. Results showed concurrent rejection in 23 of 57 (40%) of cases with rejection; 19 of 57 (33.5%) and 15 of 57 (26.5%) showed kidney or pancreas only rejection, respectively. The degree and type of rejection differed in the majority (13 of 23, 56.5%) of cases with concurrent rejection, with the pancreas more often showing higher rejection grade. Taking into account pancreas dysfunction, a positive kidney biopsy should correctly predict pancreas rejection in 86% of the instances. However, the lack of complete concordance between the 2 organs, the discrepancies in grade and type of rejection, and the tendency for higher rejection grades in concurrent or pancreas only rejections, all support the rationale for pancreas biopsies. The latter provide additional data on the overall status of the organ, as well as information on nonrejection-related pathologies.
publishDate 2019
dc.date.none.fl_str_mv 2019-02
dc.type.none.fl_str_mv info:eu-repo/semantics/article
info:eu-repo/semantics/publishedVersion
http://purl.org/coar/resource_type/c_6501
info:ar-repo/semantics/articulo
format article
status_str publishedVersion
dc.identifier.none.fl_str_mv http://hdl.handle.net/11336/88432
Uva, Pablo Daniel; Papadimitriou, J. C.; Drachenberg, Cinthia B.; Toniolo, María F.; Quevedo, Alejandra; et al.; Graft dysfunction in simultaneous pancreas kidney transplantation (SPK): Results of concurrent kidney and pancreas allograft biopsies; Wiley Blackwell Publishing, Inc; American Journal of Transplantation; 19; 2; 2-2019; 466-474
1600-6135
CONICET Digital
CONICET
url http://hdl.handle.net/11336/88432
identifier_str_mv Uva, Pablo Daniel; Papadimitriou, J. C.; Drachenberg, Cinthia B.; Toniolo, María F.; Quevedo, Alejandra; et al.; Graft dysfunction in simultaneous pancreas kidney transplantation (SPK): Results of concurrent kidney and pancreas allograft biopsies; Wiley Blackwell Publishing, Inc; American Journal of Transplantation; 19; 2; 2-2019; 466-474
1600-6135
CONICET Digital
CONICET
dc.language.none.fl_str_mv eng
language eng
dc.relation.none.fl_str_mv info:eu-repo/semantics/altIdentifier/url/https://onlinelibrary.wiley.com/doi/abs/10.1111/ajt.15012
info:eu-repo/semantics/altIdentifier/doi/10.1111/ajt.15012
dc.rights.none.fl_str_mv info:eu-repo/semantics/openAccess
https://creativecommons.org/licenses/by-nc-sa/2.5/ar/
eu_rights_str_mv openAccess
rights_invalid_str_mv https://creativecommons.org/licenses/by-nc-sa/2.5/ar/
dc.format.none.fl_str_mv application/pdf
application/pdf
application/pdf
application/pdf
dc.publisher.none.fl_str_mv Wiley Blackwell Publishing, Inc
publisher.none.fl_str_mv Wiley Blackwell Publishing, Inc
dc.source.none.fl_str_mv reponame:CONICET Digital (CONICET)
instname:Consejo Nacional de Investigaciones Científicas y Técnicas
reponame_str CONICET Digital (CONICET)
collection CONICET Digital (CONICET)
instname_str Consejo Nacional de Investigaciones Científicas y Técnicas
repository.name.fl_str_mv CONICET Digital (CONICET) - Consejo Nacional de Investigaciones Científicas y Técnicas
repository.mail.fl_str_mv dasensio@conicet.gov.ar; lcarlino@conicet.gov.ar
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score 13.265058

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