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The significance of subclinical rejection
Author(s) -
ElAmm JoseMarie,
Gruber Scott A.
Publication year - 2009
Publication title -
clinical transplantation
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.918
H-Index - 76
eISSN - 1399-0012
pISSN - 0902-0063
DOI - 10.1111/j.1399-0012.2008.00888.x
Subject(s) - medicine , subclinical infection , renal function , transplantation , clinical significance , urology , kidney transplantation , biopsy , regimen , surgery
Subclinical rejection (SCR) is quite common early following renal transplantation and decreases progressively with time. The immunological profile of the recipient, the immunosuppressive regimen used, and the occurrence of prior episodes of clinical acute rejection (AR) are all risk factors for SCR. SCR, in turn, is a risk factor for chronic interstitial and tubular fibrosis and has been associated with worse glomerular filtration rate (GFR) and graft survival. Early SCR should be initially treated with pulse steroids. SCR is a form of biopsy‐proven AR and, particularly if treated, must be fairly reported and displayed as a solid endpoint in clinical studies.