Biopsy-diagnosed renal disease in patients after transplantation of other organs and tissues
Schwarz A, Haller H, Schmitt R, Schiffer M, Koenecke C, Strassburg C, Lehner F, Gottlieb J, Bara C, Becker JU, Broecker V (2010)
Publication Type: Journal article
Publication year: 2010
Journal
Book Volume: 10
Pages Range: 2017-2025
Journal Issue: 9
DOI: 10.1111/j.1600-6143.2010.03224.x
Abstract
Renal function deteriorates in about half of patients undergoing other transplants. We report the results of 105 renal biopsies from 101 nonrenal transplant recipients (bone marrow 14, liver 41, lung 30, heart 20). Biopsy indications were protracted acute renal failure (9%), creatinine increases (83%), heavy proteinuria (22%), or renal insufficiency before re-transplantation (9%). Histological findings other than nonspecific chronic changes, hypertension-related damage, and signs of chronic CNI toxicity included primary glomerular disease (17%), mostly after liver transplantation (21%) or after bone marrow transplantation (29%), and thrombotic microangiopathy (TMA) namely (10%). TMA had the most serious impact on the clinical course. Besides severe hypertension, one TMA patient died of cerebral hemorrhage, 5 had hemolytic-uremic syndrome, and 6 rapidly developed end-stage renal failure. TMA patients had the shortest kidney survival post-biopsy and, together with patients with acute tubular injury, the shortest kidney and patient survival since transplantation. Nine TMA patients had received CNI, 3 of them concomitantly received an mTOR-inhibitor. CNI toxicity is implicated in most patients with renal failure after transplant of other organs and may play a role in the development of TMA, the most serious complication. However, decreased renal function should not be routinely ascribed to CNI. © 2010 The American Society of Transplantation and the American Society of Transplant Surgeons.
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Germany (DE)How to cite
APA:
Schwarz, A., Haller, H., Schmitt, R., Schiffer, M., Koenecke, C., Strassburg, C.,... Broecker, V. (2010). Biopsy-diagnosed renal disease in patients after transplantation of other organs and tissues. American Journal of Transplantation, 10(9), 2017-2025. https://dx.doi.org/10.1111/j.1600-6143.2010.03224.x
MLA:
Schwarz, A., et al. "Biopsy-diagnosed renal disease in patients after transplantation of other organs and tissues." American Journal of Transplantation 10.9 (2010): 2017-2025.
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