Researchers have found that kidney transplant patients with microvascular inflammation have an increased risk of rejection and long-term kidney graft loss.
- Kidney transplant patients with microvascular inflammation have a higher risk of rejection and disease progression, a new study suggests.
- Microvascular inflammation is therefore a key indicator of unfavorable graft outcomes.
- Researchers have thus discovered a new form of graft rejection.
This is a first: a new form of kidney transplant rejection has been discovered and it is linked to microvascular inflammation. Researchers from the National Institute of Health and Medical Research (Inserm), Assistance Publique – Hôpitaux de Paris (AP-HP) and Paris Cité University at the origin of this discovery have published their work in the journal New England Journal of Medicine (NEJM).
Kidney transplant: rejection may be linked to microvascular inflammation
After a kidney transplant, acute rejection may occur within three to four months following surgery, depending on the MSD Manual. There is also chronic rejection, which can occur several months or years later. When it occurs, the patient must take medication to treat the rejection in the short to medium term, but in the long term another graft must be found.
During rejection, the patient’s body attacks the transplanted organ, because the immune system perceives the graft as a foreign body. Microvascular inflammation (relating to small vessels, Editor’s note) plays an essential role in various cases of graft rejection. But, itth phenomenon remains poorly understood by doctors.
To better understand this, scientists worked on 16,000 biopsies from just under 7,000 patients who had received a kidney transplant in 30 centers in seven countries in Europe and North America. This allows different clinical practices to be compared.
“Our study provides critical evidence that microvascular inflammation is a key indicator of poor long-term kidney graft outcomes”, indicates Dr Marta Sablik, co-first author of the study, in a press release.
Graft rejection: towards better risk management
“Researchers found that kidney transplant patients with microvascular inflammation had an increased risk of disease progression and long-term kidney graft loss”, specifies the press release. This allowed them to characterize a new form of kidney transplant rejection linked to microvascular inflammation.
“These results highlight the importance of a better understanding of renal microvascular inflammation to improve diagnostic accuracy and therapeutic approaches.”, underlines Dr Aurélie Sannier, another co-first author of the study.
Ultimately, this study could make it possible to better anticipate the risks of rejection and better care for patients. Before that, new clinical trials still need to be conducted to better understand how microvascular inflammation acts on the graft.
“This research represents a major advance in kidney transplant medicine, for optimized patient care, explains Alexandre Loupy, who coordinated the study. Furthermore, these results open significant avenues to better elucidate the mechanisms of organ rejection with repercussions in other fields such as heart, liver, lung and composite tissue transplantation as well as in xenotransplantation where our team recently demonstrated similar rejection mechanisms involving microcirculation”.
