Sistema de Salut de Catalunya
Institut Català de la Salut
[Becker JU] Institute of Pathology, University Hospital Cologne, Cologne, Germany. [Seron D] Servei de Nefrologia, Vall d’Hebron Hospital Universitari, Barcelona, Spain. [Rabant M] Department of Pathology, Hôpital Necker–Enfants Malades, Paris, France. [Roufosse C] Centre for Inflammatory Disease, Department of Immunology and Inflammation, Imperial College London, London, United Kingdom. [Naesens M] Department of Microbiology, Immunology and Transplantation, KU Leuven, Leuven, Belgium
Vall d'Hebron Barcelona Hospital Campus
2023-01-09T18:16:32Z
2023-01-09T18:16:32Z
2022-05-20
T cell-mediated rejection; Biopsy; Subclinical rejection
Rechazo mediado por células T; Biopsia; Rechazo subclínico
Rebuig mediat per cèl·lules T; Biòpsia; Rebuig subclínic
This article outlines the evolving definition of rejection following kidney transplantation. The viewpoints and evidence presented were included in documentation prepared for a Broad Scientific Advice request to the European Medicines Agency (EMA), relating to clinical trial endpoints in kidney transplantation. This request was initiated by the European Society for Organ Transplantation (ESOT) in 2016 and finalized following discussions between the EMA and ESOT in 2020. In ESOT’s opinion, the use of “biopsy-proven acute rejection” as an endpoint for clinical trials in kidney transplantation is no longer accurate, although it is still the approved histopathological endpoint. The spectrum of rejection is now divided into the phenotypes of borderline changes, T cell-mediated rejection, and antibody-mediated rejection, with the latter two phenotypes having further subclassifications. Rejection is also described in relation to graft (dys)function, diagnosed because of protocol (surveillance) or indication (for-cause) biopsies. The ongoing use of outdated terminology has become a potential barrier to clinical research in kidney transplantation. This article presents these perspectives and issues, and provides a foundation on which subsequent articles within this Special Issue of Transplant International build.
This initiative was supported by the European Society for Organ Transplantation.
Article
Versió publicada
Anglès
Ronyons - Trasplantació; Immunoglobulines; Rebuig (Biologia); ANALYTICAL, DIAGNOSTIC AND THERAPEUTIC TECHNIQUES, AND EQUIPMENT::Therapeutics::Renal Replacement Therapy::Kidney Transplantation; PHENOMENA AND PROCESSES::Immune System Phenomena::Transplantation Immunology::Host vs Graft Reaction::Graft Rejection; CHEMICALS AND DRUGS::Amino Acids, Peptides, and Proteins::Proteins::Blood Proteins::Immunoproteins::Immunoglobulins::Antibodies; TÉCNICAS Y EQUIPOS ANALÍTICOS, DIAGNÓSTICOS Y TERAPÉUTICOS::terapéutica::tratamiento de reemplazo renal::trasplante de riñón; FENÓMENOS Y PROCESOS::fenómenos del sistema inmunitario::inmunología del trasplante::reacción huésped contra injerto::rechazo del injerto; COMPUESTOS QUÍMICOS Y DROGAS::aminoácidos, péptidos y proteínas::proteínas::proteínas sanguíneas::inmunoproteínas::inmunoglobulinas::anticuerpos
Frontiers Media
Transplant International;35
https://doi.org/10.3389/ti.2022.10141
Attribution 4.0 International
http://creativecommons.org/licenses/by/4.0/
Articles científics - HVH [3436]
