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Plasma cell infiltrates and renal allograft outcomes in indigenous and non-indigenous people of the Northern Territory of Australia

Citation

Rogers, NM and Lawton, PD and Jose, MD, Plasma cell infiltrates and renal allograft outcomes in indigenous and non-indigenous people of the Northern Territory of Australia, Nephrology, 16, (8) pp. 777-783. ISSN 1320-5358 (2011) [Refereed Article]


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The definitive published version is available online at: http://www3.interscience.wiley.com/

DOI: doi:10.1111/j.1440-1797.2011.01487.x

Abstract

Introduction: Plasma cell-rich rejection is a distinct histological phenomenon associated with poor renal allograft outcomes. Aboriginal and Torres Straight Islander (ATSI) transplant recipients have poorer allograft survival and higher rates of acute rejection. We sought to determine whether a higher incidence of plasma cell-rich infiltrates (PCIR) could account for poorer survival. Methods: Renal transplant biopsies performed in recipients from the Northern Territory of Australia between 1985 and 2007 were reviewed and correlated with outcome. Biopsies were designated PCIR positive when plasma cells constituted >10% of the interstitial infiltrate. Results: Four hundred and seventy-seven biopsies from 177 recipients (108 ATSI) were performed. Median graft survival was shorter for recipients with PCIR: 4.0 years (interquartile range 2.18–6.41) versus 5.4 years (2.0–9.99) (P = 0.013). ATSI recipients had higher rates of plasma cell-rich rejection (RR 1.76, 95% CI 1.43–2.17, P < 0.0001), which occurred earlier (251 vs 869 days, P = 0.03) compared with non-indigenous recipients. On multivariate analysis, PCIR did not independently influence allograft survival. There was a correlation between PCIR and panel reactive antibody peak >20% (RR 1.29, 95% CI 1.03–1.56, P = 0.025), 5 human leukocyte antigen mismatches (RR 1.91, 1.41–2.58, p < 0.0001), increasing post-transplant infection rate (>10 infections RR 5.11, 1.69–15.5, P = 0.004), and subsequent death from septicaemia (RR 1.6, 1.17–2.18, P = 0.003). Conclusion: PCIR is associated with infection and markers of chronic immunological stimulation but does not independently contribute to inferior renal allograft outcomes, even in ATSI recipients.

Item Details

Item Type:Refereed Article
Keywords:indigenous, kidney transplant, outcome, plasma cells
Research Division:Medical and Health Sciences
Research Group:Clinical Sciences
Research Field:Nephrology and Urology
Objective Division:Health
Objective Group:Indigenous Health
Objective Field:Aboriginal and Torres Strait Islander Health - Health Status and Outcomes
Author:Jose, MD (Professor Matthew Jose)
ID Code:73962
Year Published:2011
Web of Science® Times Cited:4
Deposited By:Menzies Institute for Medical Research
Deposited On:2011-11-02
Last Modified:2017-11-06
Downloads:0

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