Early Posttransplant Isolated v1 Lesion Does Not Need to Be Treated and Does Not Lead to Increased Fibrosis
Acute vascular rejection (AVR) is characterized by intimal arteritis in addition to tubulitis and interstitial inflammation. It is associated with a poorer prognosis compared to tubulointerstitial rejection (AIR) and AVR is associated with a higher rate of graft loss than AIR. The prognosis and trea...
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| Format: | Article |
| Language: | English |
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Wiley
2016-01-01
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| Series: | Case Reports in Transplantation |
| Online Access: | http://dx.doi.org/10.1155/2016/4603014 |
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| author | Irfan Moinuddin Bijin Thajudeen Amy Sussman Machaiah Madhrira Erika Bracamonte Mordecai Popovtzer Pradeep V. Kadambi |
| author_facet | Irfan Moinuddin Bijin Thajudeen Amy Sussman Machaiah Madhrira Erika Bracamonte Mordecai Popovtzer Pradeep V. Kadambi |
| author_sort | Irfan Moinuddin |
| collection | DOAJ |
| description | Acute vascular rejection (AVR) is characterized by intimal arteritis in addition to tubulitis and interstitial inflammation. It is associated with a poorer prognosis compared to tubulointerstitial rejection (AIR) and AVR is associated with a higher rate of graft loss than AIR. The prognosis and treatment of arteritis without tubulitis and interstitial inflammation (isolated v1 lesion) are still controversial. We report a case of a patient who had a biopsy of the kidney allograft for evaluation of slow graft function. The biopsy revealed an isolated v1 lesion. However, we chose not to augment immunosuppression. The patient’s kidney allograft function improved over time with close monitoring. Repeat biopsy a year later showed no evidence of endothelialitis and relatively unchanged fibrosis and no other abnormalities. Although it is suggested that most cases of isolated v1 lesions will respond to corticosteroids or T cell depleting therapies, some cases will improve with conservative management. Further studies are needed to determine which cases could be managed conservatively. |
| format | Article |
| id | doaj-art-11bc72f91f7e427c98ef631e0ecc1d04 |
| institution | Kabale University |
| issn | 2090-6943 2090-6951 |
| language | English |
| publishDate | 2016-01-01 |
| publisher | Wiley |
| record_format | Article |
| series | Case Reports in Transplantation |
| spelling | doaj-art-11bc72f91f7e427c98ef631e0ecc1d042025-02-03T01:07:17ZengWileyCase Reports in Transplantation2090-69432090-69512016-01-01201610.1155/2016/46030144603014Early Posttransplant Isolated v1 Lesion Does Not Need to Be Treated and Does Not Lead to Increased FibrosisIrfan Moinuddin0Bijin Thajudeen1Amy Sussman2Machaiah Madhrira3Erika Bracamonte4Mordecai Popovtzer5Pradeep V. Kadambi6Division of Nephrology, University of Arizona, Tucson, AZ 85724, USADivision of Nephrology, University of Arizona, Tucson, AZ 85724, USADivision of Nephrology, University of Arizona, Tucson, AZ 85724, USADivision of Nephrology, University of Arizona, Tucson, AZ 85724, USADepartment of Pathology, University of Arizona, Tucson, AZ 85724, USADivision of Nephrology, University of Arizona, Tucson, AZ 85724, USADivision of Nephrology, University of Arizona, Tucson, AZ 85724, USAAcute vascular rejection (AVR) is characterized by intimal arteritis in addition to tubulitis and interstitial inflammation. It is associated with a poorer prognosis compared to tubulointerstitial rejection (AIR) and AVR is associated with a higher rate of graft loss than AIR. The prognosis and treatment of arteritis without tubulitis and interstitial inflammation (isolated v1 lesion) are still controversial. We report a case of a patient who had a biopsy of the kidney allograft for evaluation of slow graft function. The biopsy revealed an isolated v1 lesion. However, we chose not to augment immunosuppression. The patient’s kidney allograft function improved over time with close monitoring. Repeat biopsy a year later showed no evidence of endothelialitis and relatively unchanged fibrosis and no other abnormalities. Although it is suggested that most cases of isolated v1 lesions will respond to corticosteroids or T cell depleting therapies, some cases will improve with conservative management. Further studies are needed to determine which cases could be managed conservatively.http://dx.doi.org/10.1155/2016/4603014 |
| spellingShingle | Irfan Moinuddin Bijin Thajudeen Amy Sussman Machaiah Madhrira Erika Bracamonte Mordecai Popovtzer Pradeep V. Kadambi Early Posttransplant Isolated v1 Lesion Does Not Need to Be Treated and Does Not Lead to Increased Fibrosis Case Reports in Transplantation |
| title | Early Posttransplant Isolated v1 Lesion Does Not Need to Be Treated and Does Not Lead to Increased Fibrosis |
| title_full | Early Posttransplant Isolated v1 Lesion Does Not Need to Be Treated and Does Not Lead to Increased Fibrosis |
| title_fullStr | Early Posttransplant Isolated v1 Lesion Does Not Need to Be Treated and Does Not Lead to Increased Fibrosis |
| title_full_unstemmed | Early Posttransplant Isolated v1 Lesion Does Not Need to Be Treated and Does Not Lead to Increased Fibrosis |
| title_short | Early Posttransplant Isolated v1 Lesion Does Not Need to Be Treated and Does Not Lead to Increased Fibrosis |
| title_sort | early posttransplant isolated v1 lesion does not need to be treated and does not lead to increased fibrosis |
| url | http://dx.doi.org/10.1155/2016/4603014 |
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