Usefulness of oxford classification in assessing immunoglobulin a nephropathy after transplantation

Beom Jin Lim, Dong Jin Joo, Myoung Soo Kim, Yu Seun Kim, Soon Il Kim, Yeonhee Kim, Kyu Ha Huh, Myung Ju Koh, Hyeon Joo Jeong

Research output: Contribution to journalArticle

11 Citations (Scopus)

Abstract

Background. We explored the efficacy of the Oxford classification for assessing native immunoglobulin A nephropathy (IgAN) in posttransplantation patients compared with the glomerular injury score and Haas classification. Methods. A total of 125 renal allograft biopsies obtained from 114 patients diagnosed with IgAN regardless of original disease were assessed. Results. The average time to biopsy was 70.5T45.3 months after transplantation. Glomeruli showed normal histology in 18.4%. Mesangial hypercellularity (M1), endocapillary hypercellularity (E1), segmental glomerulosclerosis (S1), and tubulointerstitial fibrosis (T1-2) were present in 12.8%, 6.4%, 45.6%, and 20.8% of the samples, respectively. There was a significant correlation between Oxford-MEST scores and glomerular injury score or Haas subclass. S1 and T1-2 were correlated with elevated serum creatinine level, proteinuria, and decreased estimated glomerular filtration rate, and E1 was correlated with decreased estimated glomerular filtration rate at the time of biopsy. The 10-and 15-year graft survival rates were 62.9% and 34.3%, respectively. The graft survival rate was significantly lower in the presence of S1 and T1-2. Endocapillary hypercellularity, segmental sclerosis, and tubulointerstitial fibrosis predicted graft survival and endocapillary hypercellularity and tubulointerstitial fibrosis also predicted serum creatinine doubling. Conclusions. The Oxford classification scheme is useful for evaluating chronic graft dysfunction in patients with posttransplantation IgAN. In addition to tubulointerstitial fibrosis, the presence of endocapillary hypercellularity and segmental sclerosis should be included in the pathology report.

Original languageEnglish
Pages (from-to)1491-1497
Number of pages7
JournalTransplantation
Volume95
Issue number12
DOIs
Publication statusPublished - 2013 Jun 27

Fingerprint

IGA Glomerulonephritis
Immunoglobulins
Fibrosis
Graft Survival
Transplantation
Sclerosis
Glomerular Filtration Rate
Biopsy
Creatinine
Survival Rate
Wounds and Injuries
Serum
Proteinuria
Allografts
Histology
Pathology
Transplants
Kidney

All Science Journal Classification (ASJC) codes

  • Transplantation

Cite this

Lim, Beom Jin ; Joo, Dong Jin ; Kim, Myoung Soo ; Kim, Yu Seun ; Kim, Soon Il ; Kim, Yeonhee ; Huh, Kyu Ha ; Koh, Myung Ju ; Jeong, Hyeon Joo. / Usefulness of oxford classification in assessing immunoglobulin a nephropathy after transplantation. In: Transplantation. 2013 ; Vol. 95, No. 12. pp. 1491-1497.
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title = "Usefulness of oxford classification in assessing immunoglobulin a nephropathy after transplantation",
abstract = "Background. We explored the efficacy of the Oxford classification for assessing native immunoglobulin A nephropathy (IgAN) in posttransplantation patients compared with the glomerular injury score and Haas classification. Methods. A total of 125 renal allograft biopsies obtained from 114 patients diagnosed with IgAN regardless of original disease were assessed. Results. The average time to biopsy was 70.5T45.3 months after transplantation. Glomeruli showed normal histology in 18.4{\%}. Mesangial hypercellularity (M1), endocapillary hypercellularity (E1), segmental glomerulosclerosis (S1), and tubulointerstitial fibrosis (T1-2) were present in 12.8{\%}, 6.4{\%}, 45.6{\%}, and 20.8{\%} of the samples, respectively. There was a significant correlation between Oxford-MEST scores and glomerular injury score or Haas subclass. S1 and T1-2 were correlated with elevated serum creatinine level, proteinuria, and decreased estimated glomerular filtration rate, and E1 was correlated with decreased estimated glomerular filtration rate at the time of biopsy. The 10-and 15-year graft survival rates were 62.9{\%} and 34.3{\%}, respectively. The graft survival rate was significantly lower in the presence of S1 and T1-2. Endocapillary hypercellularity, segmental sclerosis, and tubulointerstitial fibrosis predicted graft survival and endocapillary hypercellularity and tubulointerstitial fibrosis also predicted serum creatinine doubling. Conclusions. The Oxford classification scheme is useful for evaluating chronic graft dysfunction in patients with posttransplantation IgAN. In addition to tubulointerstitial fibrosis, the presence of endocapillary hypercellularity and segmental sclerosis should be included in the pathology report.",
author = "Lim, {Beom Jin} and Joo, {Dong Jin} and Kim, {Myoung Soo} and Kim, {Yu Seun} and Kim, {Soon Il} and Yeonhee Kim and Huh, {Kyu Ha} and Koh, {Myung Ju} and Jeong, {Hyeon Joo}",
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Lim, BJ, Joo, DJ, Kim, MS, Kim, YS, Kim, SI, Kim, Y, Huh, KH, Koh, MJ & Jeong, HJ 2013, 'Usefulness of oxford classification in assessing immunoglobulin a nephropathy after transplantation', Transplantation, vol. 95, no. 12, pp. 1491-1497. https://doi.org/10.1097/TP.0b013e318291de65

Usefulness of oxford classification in assessing immunoglobulin a nephropathy after transplantation. / Lim, Beom Jin; Joo, Dong Jin; Kim, Myoung Soo; Kim, Yu Seun; Kim, Soon Il; Kim, Yeonhee; Huh, Kyu Ha; Koh, Myung Ju; Jeong, Hyeon Joo.

In: Transplantation, Vol. 95, No. 12, 27.06.2013, p. 1491-1497.

Research output: Contribution to journalArticle

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T1 - Usefulness of oxford classification in assessing immunoglobulin a nephropathy after transplantation

AU - Lim, Beom Jin

AU - Joo, Dong Jin

AU - Kim, Myoung Soo

AU - Kim, Yu Seun

AU - Kim, Soon Il

AU - Kim, Yeonhee

AU - Huh, Kyu Ha

AU - Koh, Myung Ju

AU - Jeong, Hyeon Joo

PY - 2013/6/27

Y1 - 2013/6/27

N2 - Background. We explored the efficacy of the Oxford classification for assessing native immunoglobulin A nephropathy (IgAN) in posttransplantation patients compared with the glomerular injury score and Haas classification. Methods. A total of 125 renal allograft biopsies obtained from 114 patients diagnosed with IgAN regardless of original disease were assessed. Results. The average time to biopsy was 70.5T45.3 months after transplantation. Glomeruli showed normal histology in 18.4%. Mesangial hypercellularity (M1), endocapillary hypercellularity (E1), segmental glomerulosclerosis (S1), and tubulointerstitial fibrosis (T1-2) were present in 12.8%, 6.4%, 45.6%, and 20.8% of the samples, respectively. There was a significant correlation between Oxford-MEST scores and glomerular injury score or Haas subclass. S1 and T1-2 were correlated with elevated serum creatinine level, proteinuria, and decreased estimated glomerular filtration rate, and E1 was correlated with decreased estimated glomerular filtration rate at the time of biopsy. The 10-and 15-year graft survival rates were 62.9% and 34.3%, respectively. The graft survival rate was significantly lower in the presence of S1 and T1-2. Endocapillary hypercellularity, segmental sclerosis, and tubulointerstitial fibrosis predicted graft survival and endocapillary hypercellularity and tubulointerstitial fibrosis also predicted serum creatinine doubling. Conclusions. The Oxford classification scheme is useful for evaluating chronic graft dysfunction in patients with posttransplantation IgAN. In addition to tubulointerstitial fibrosis, the presence of endocapillary hypercellularity and segmental sclerosis should be included in the pathology report.

AB - Background. We explored the efficacy of the Oxford classification for assessing native immunoglobulin A nephropathy (IgAN) in posttransplantation patients compared with the glomerular injury score and Haas classification. Methods. A total of 125 renal allograft biopsies obtained from 114 patients diagnosed with IgAN regardless of original disease were assessed. Results. The average time to biopsy was 70.5T45.3 months after transplantation. Glomeruli showed normal histology in 18.4%. Mesangial hypercellularity (M1), endocapillary hypercellularity (E1), segmental glomerulosclerosis (S1), and tubulointerstitial fibrosis (T1-2) were present in 12.8%, 6.4%, 45.6%, and 20.8% of the samples, respectively. There was a significant correlation between Oxford-MEST scores and glomerular injury score or Haas subclass. S1 and T1-2 were correlated with elevated serum creatinine level, proteinuria, and decreased estimated glomerular filtration rate, and E1 was correlated with decreased estimated glomerular filtration rate at the time of biopsy. The 10-and 15-year graft survival rates were 62.9% and 34.3%, respectively. The graft survival rate was significantly lower in the presence of S1 and T1-2. Endocapillary hypercellularity, segmental sclerosis, and tubulointerstitial fibrosis predicted graft survival and endocapillary hypercellularity and tubulointerstitial fibrosis also predicted serum creatinine doubling. Conclusions. The Oxford classification scheme is useful for evaluating chronic graft dysfunction in patients with posttransplantation IgAN. In addition to tubulointerstitial fibrosis, the presence of endocapillary hypercellularity and segmental sclerosis should be included in the pathology report.

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