biostudies-literatureUnknown8(10)Whigham MThe Banff classification scheme provides a framework for interpreting transplant kidney biopsies and has undergone various updates in the past 2 decades especially related to antibody-mediated rejection. The clinical significance of early glomerulitis seen within 4 mo on protocol biopsies has received limited attention. We hypothesized that early glomerulitis seen on protocol biopsies will lead to significant adverse outcomes as assessed by histopathology and allograft outcome.<h4>Methods</h4>A single-center retrospective study of a cohort of patients who underwent protocol biopsies within 4 mo after transplantation with timely follow-up protocol biopsies were assessed. Patients with recurrent glomerulonephritis were excluded.<h4>Results</h4>We calculated glomerulitis (g) scores for 2212 biopsy specimens and identified 186 patients with glomerulitis (g > 0) and 2026 patients without glomerulitis (g = 0). The progression to chronic transplant glomerulopathy at 1 and 2 y was higher in patients with g > 0 as compared with g = 0 (year 1, 10.7% versus 2.3% [<i>P</i> < 0.001]' respectively; year 2, 17.2% versus 4.3% [<i>P</i> < 0.001], respectively) with no difference in other chronic lesions. The death-censored graft failure rate was higher in patients with g > 0 as compared with g = 0 (hazard ratio, 1.68 [95% CI, 1.07-2.65]; <i>P</i> = 0.02). We did not find any difference in outcomes in glomerulitis group based on donor-specific antibody.<h4>Conclusion</h4>Our findings suggest that early glomerulitis (seen within 4 mo after transplantation) may lead to clinically significant long-term changes and thus could be a target for early intervention therapies.Transplantation directe1381https://www.ebi.ac.uk/biostudies/studies/S-EPMC9529059biostudies-literatureImpact of Glomerulitis on Long-term Outcomes After Kidney Transplantation.PMC9529059Ryan MSLim ESWhigham MRamon DSMour GKNair SSHeilman RLJaramillo ABuras MRfalseImpact of Glomerulitis on Long-term Outcomes After Kidney Transplantation.The Banff classification scheme provides a framework for interpreting transplant kidney biopsies and has undergone various updates in the past 2 decades especially related to antibody-mediated rejection. The clinical significance of early glomerulitis seen within 4 mo on protocol biopsies has received limited attention. We hypothesized that early glomerulitis seen on protocol biopsies will lead to significant adverse outcomes as assessed by histopathology and allograft outcome.<h4>Methods</h4>A single-center retrospective study of a cohort of patients who underwent protocol biopsies within 4 mo after transplantation with timely follow-up protocol biopsies were assessed. Patients with recurrent glomerulonephritis were excluded.<h4>Results</h4>We calculated glomerulitis (g) scores for 2212 biopsy specimens and identified 186 patients with glomerulitis (g > 0) and 2026 patients without glomerulitis (g = 0). The progression to chronic transplant glomerulopathy at 1 and 2 y was higher in patients with g > 0 as compared with g = 0 (year 1, 10.7% versus 2.3% [<i>P</i> < 0.001]' respectively; year 2, 17.2% versus 4.3% [<i>P</i> < 0.001], respectively) with no difference in other chronic lesions. The death-censored graft failure rate was higher in patients with g > 0 as compared with g = 0 (hazard ratio, 1.68 [95% CI, 1.07-2.65]; <i>P</i> = 0.02). We did not find any difference in outcomes in glomerulitis group based on donor-specific antibody.<h4>Conclusion</h4>Our findings suggest that early glomerulitis (seen within 4 mo after transplantation) may lead to clinically significant long-term changes and thus could be a target for early intervention therapies.2022-01-01T00:00:00Z2022 Oct2025-04-04T09:24:25.082Z2025-04-04T09:24:25.082ZS-EPMC95290593620418810.1097/TXD.0000000000001381