A sick kidney, while not as well-known as the heart or the brain, can be equally dangerous, weakening the heart bones and immune system, not to mention the kidney itself. The prognosis for end-stage kidney illness is the worst, and the only cure is a kidney transplant which comes with its own set of hazards.
Diagnosing And Predicting The Success Of Kidney Transplants
Last year approximately 100000 kidney transplants were performed ten times as many as heart or lung transplants. Furthermore, five out of every six individuals on the waiting list for an organ donor require a kidney transplant. There is no certainty that the patient will be cured even if a donor is identified.
Professor Motoko Yanagita of ASHBi discovered that tertiary lymphoid tissues, a common but hitherto unrecognized discovery of kidney grafts, are a significant prognosis marker of graft outcome. The new research was published in the American Society of Nephrology’s Journal.
“Graft survival in the short-term has greatly improved in the last three decades, but long-term survival has only improved marginally,” said Yanagita, a kidney disease expert.
In the past few decades, the incidents of kidney failure have increased to a significant level, and more and more people have to go for a transplant across the USA these days. That is why it is important for the experts to check if the body will be able to accept the new kidney before it is transplanted, for which this model is developed.
To put it another way, tertiary lymphoid tissues are a normal result of aging and the health problems that come with it. While the medical community is aware of the presence of tertiary lymphoid tissues in kidney transplants, little is known regarding their importance in graft survival.
Inflammation is one of the most common signs of a failed transplant. Tertiary lymphoid tissues, which the study defines as “inducible ectopic lymphoid tissues that form in chronic inflammatory circumstances such as aging cancer autoimmune illness and transplanted organs,” are frequently associated with inflammation.
The current study looked at 214 kidney transplant recipients who had shown no signs of rejection. To verify there was no rejection, each patient had kidney biopsies performed immediately 1, 6, and 12 months following the transplant. Tertiary lymphoid tissues were scarcely visible immediately after transplantation but were present in around half of the patients after one month.
The relevance of tertiary lymphoid tissues has been overlooked in part because doctors and scientists were unaware of the various stages of the tissues. Prof. Yanagita’s research revealed two stages last year differentiated by the lack (stage I) and presence (stage II) of follicular dendritic cells, a kind of fibroblast found naturally in the human body.
Stage II tertiary lymphoid tissues, on the other hand, were found in less than 10% of biopsies after six months and over 20% after a year. Patients having stage II tertiary lymphoid tissues in their biopsies, on the other hand, had a considerably increased chance of developing renal failure within five years following transplantation.
“The patients with stage II tertiary lymphoid tissues showed a higher risk of future decline in graft function,” said Yanagita.
“Stage II tertiary lymphoid tissues were observed in graft tissues that had mild interstitial inflammation. These findings suggest that tertiary lymphoid tissues are qualitatively different from simple interstitial inflammation and might be regarded as novel histological markers of graft outcomes,” Yanagita said.
Furthermore, the existence of stage II tertiary lymphoid tissues did not always correlate with the inflammatory score of the Banff classification, a standard grading method used by clinicians to grade biopsies following solid organ transplants, she added. The stage II tertiary lymphoid tissues could be another important diagnostic sign for graft survival in kidney transplantation.
