New Warning Signs That may Predict Kidney Transplant Failure Revealed

A new study has suggested that kidney transplants that show a combination of fibrosis (scarring) and inflammation after one year are at higher risk of long-term transplant failure.

The researchers analyzed factors related to transplant survival in 151 patients who had no apparent problems after living-donor kidney transplantation.

About Transplantation
Since the early times, the novel idea of transplanting tissues and other body parts from one organism to the other has captured the imagination of successive generations.

One-year biopsies showed no abnormalities in 57 percent of kidneys; another 30 percent had fibrosis (scarring) but no inflammation. In these two groups, the transplanted kidney continued to function normally from one to five years' follow-up.

However, in the remaining 13 percent of transplants, the biopsies showed fibrosis plus inflammation. These transplants had declining kidney function and a reduced long-term survival rate. Kidneys showing fibrosis plus inflammation also had increased numbers of immune cells as well as a "rejection-like" gene expression signature.

Thus, in apparently normal kidney transplants, biopsies showing fibrosis and inflammation signal kidney damage and an increased risk of long-term failure. "It is likely that the intragraft environment of patients with fibrosis and inflammation is damaging to the allograft," says Stegall.

Quiz on Kidney
The kidneys are two bean-shaped organs, each about the size of a fist, and are located just below the rib cage, one on each side of your spine.

Healthy kidneys filter about half a cup of blood every minute, removing wastes and extra water to make urine. The urine flows from the kidneys to the bladder through two thin tubes of muscle called ureters, one on each side of your bladder. The bladder stores urine. The kidneys, ureters, and bladder are partof the urinary tract.

kidneys remove wastes and extra fluid from your body. Kidneys also remove acid that is produced by the cells of your body and maintain a healthy balance of water, salts, and minerals-such as sodium, calcium, phosphorus and potassium-in your blood ().

Without this balance, nerves, muscles, and other tissues in the body may not work normally.

Anatomy of Urinary System
Animation & slides showing anatomy of urinary system and the role of kidneys in getting rid of the waste products and excess fluid from our body to keep us healthy.

Kidneys also make hormones that help

Control your blood pressure
Make red blood cells
Keep your bones strong and healthy

Without routine "protocol" biopsies, these warning signs would go undetected until clinical abnormalities developed, comments Mark D. Stegall, MD (Mayo Clinic, Rochester, MN).

"The use of protocol biopsies allows for more detailed investigations of the intragraft environment," he says.

"Such routine biopsies could provide a unique way to predict which kidney transplant recipients may be at increased risk for loss of kidney function, or to identify potential targets for early preventative treatment."

The study appears in an upcoming issue of the Journal of the American Society of Nephrology (JASN).

Source-ANI