[{"data":1,"prerenderedAt":-1},["ShallowReactive",2],{"detail-sidebar-cat-0-en-105":3,"doc-seo-618483-105":59,"doc-detail-618483-en":129},{"code":4,"msg":5,"data":6},0,"success",[7,13,18,23,28,33,38,43,48,51,55],{"id":8,"doc_module":4,"doc_module_name":9,"category_name":10,"show_sort_weight":11,"slug":12},1,"Document","Story & Novel",90,"story-novel",{"id":14,"doc_module":4,"doc_module_name":9,"category_name":15,"show_sort_weight":16,"slug":17},2,"Literature",80,"literature",{"id":19,"doc_module":4,"doc_module_name":9,"category_name":20,"show_sort_weight":21,"slug":22},4,"Exam",70,"exam",{"id":24,"doc_module":4,"doc_module_name":9,"category_name":25,"show_sort_weight":26,"slug":27},5,"Comic",60,"comic",{"id":29,"doc_module":4,"doc_module_name":9,"category_name":30,"show_sort_weight":31,"slug":32},6,"Technology",50,"technology",{"id":34,"doc_module":4,"doc_module_name":9,"category_name":35,"show_sort_weight":36,"slug":37},7,"Healthcare",40,"healthcare",{"id":39,"doc_module":4,"doc_module_name":9,"category_name":40,"show_sort_weight":41,"slug":42},8,"Research & Report",30,"research-report",{"id":44,"doc_module":4,"doc_module_name":9,"category_name":45,"show_sort_weight":46,"slug":47},9,"Religion & Spirituality",20,"religion-spirituality",{"id":46,"doc_module":4,"doc_module_name":9,"category_name":49,"show_sort_weight":46,"slug":50},"World Cup","world-cup",{"id":52,"doc_module":4,"doc_module_name":9,"category_name":53,"show_sort_weight":52,"slug":54},10,"Lifestyle","lifestyle",{"id":56,"doc_module":4,"doc_module_name":9,"category_name":57,"show_sort_weight":24,"slug":58},19,"General","general",{"code":4,"msg":60,"data":61},"ok",{"site_id":62,"language":63,"slug":64,"title":65,"keywords":66,"description":67,"schema_data":68,"social_meta":122,"head_meta":124,"extra_data":126,"updated_unix":128},105,"en","microvascular-inflammation-in-kidney-transplantation-clinical-research","Microvascular Inflammation in Kidney Transplantation - Clinical Research","","Background Microvascular inflammation, defined as the sum of glomerulitis and peritubular capillaritis scores ≥2, often presents without donor-specific anti-HLA antibodies and frequently co-occurs with T-cell–mediated rejection, yet its independent prognostic role is uncertain. Methods A consecutive single-center cohort of 689 kidney transplant recipients (2004–2021) evaluated first microvascular inflammation, TCMR, and de novo DSA events on death-censored allograft loss using Cox models with time-dependent covariates. Results In combined models, first TCMR and dnDSA remained independently associated with allograft loss, while microvascular inflammation without DSA did not. Conclusions In a modern tacrolimus-based cohort, microvascular inflammation with no DSA was not linked to worse outcomes after adjustment.",{"@graph":69,"@context":121},[70,84,104],{"@type":71,"itemListElement":72},"BreadcrumbList",[73,77,79,82],{"item":74,"name":75,"@type":76,"position":8},"https://docshare.wps.com","Home","ListItem",{"item":78,"name":9,"@type":76,"position":14},"https://docshare.wps.com/document/",{"item":80,"name":40,"@type":76,"position":81},"https://docshare.wps.com/document/research-report/",3,{"item":83,"name":65,"@type":76,"position":19},"https://docshare.wps.com/document/microvascular-inflammation-in-kidney-transplantation-clinical-research/618483/",{"url":83,"name":65,"@type":85,"image":86,"author":91,"headline":65,"publisher":94,"fileFormat":97,"inLanguage":63,"description":67,"dateModified":98,"datePublished":98,"encodingFormat":97,"isAccessibleForFree":99,"interactionStatistic":100},"DigitalDocument",{"url":87,"@type":88,"width":89,"height":90},"https://docshare.wps.com/thumbnails/microvascular-inflammation-in-kidney-transplantation-clinical-research/618483.png","ImageObject",300,407,{"name":92,"@type":93},"eBook King","Person",{"url":74,"name":95,"@type":96},"DocShare","Organization","application/pdf","2026-10-19",true,{"@type":101,"interactionType":102,"userInteractionCount":4},"InteractionCounter",{"@type":103},"ViewAction",{"@type":105,"mainEntity":106},"FAQPage",[107,113,117],{"name":108,"@type":109,"acceptedAnswer":110},"How is microvascular inflammation defined in this study?","Question",{"text":111,"@type":112},"Microvascular inflammation is defined as the sum of Banff glomerulitis (g) and peritubular capillaritis (ptc) scores, with g1ptc≥2 used for the primary first-event assessment.","Answer",{"name":114,"@type":109,"acceptedAnswer":115},"What patient cohort and time span were analyzed?",{"text":116,"@type":112},"The study analyzed a consecutive single-center cohort of 689 kidney transplant recipients from 2004 to 2021.",{"name":118,"@type":109,"acceptedAnswer":119},"Did microvascular inflammation without donor-specific anti-HLA antibodies worsen prognosis independently?",{"text":120,"@type":112},"No. In time-dependent combined models adjusting for serial or concomitant TCMR and de novo DSA events, microvascular inflammation without donor-specific anti-HLA antibody did not independently worsen death-censored allograft prognosis.","https://schema.org",{"og:url":83,"og:type":123,"og:title":65,"og:site_name":95,"og:description":67},"article",{"robots":125,"canonical":83},"index,follow",{"doc_id":127,"site_id":62},618483,1792448580,{"code":4,"msg":5,"data":130},{"doc_id":127,"user_id":131,"nickname":92,"user_avatar":132,"doc_module":4,"category_id":39,"category_name":40,"doc_title":65,"doc_description":67,"doc_content":133,"file_id":134,"file_url":135,"file_type":136,"file_size":137,"view_count":4,"is_deleted":4,"is_public":8,"is_downloadable":8,"audit_status":8,"page_count":44,"language":138,"language_code":63,"site_id":62,"html_lang":63,"table_of_contents":139,"faqs":140,"seo_title":141,"seo_description":67,"update_tm":128,"read_time":142},962088006270,"https://ap-avatar.wpscdn.com/davatar_085a072bc5b1113ac321206ff7593b45","Clinical Research  \nMicrovascular Inflammation in Kidney Transplantation  \nEmmett Tsz Yeung Wong , 1,2,3 Robert Balshaw ,4 Ian W. Gibson ,5, 6 Julie Ho  , 1,5 Jamie Shaw , 1 Martin Karpinski, 1 Aaron Trachtenberg , 1 Denise Pochinco  ,5 Aviva Goldberg ,7 Patricia Birk ,7 Maury Pinsk ,7 David N. Rush  , 1,5 Peter W. Nickerson  , 1,5,8 and Chris Wiebe  1,5,8  \nKey Points  \nc De novo donor-specific anti-HLA antibody, microvascular inflammation, and T-cell–mediated rejection events frequently occurred concomitantly or serially, and their interconnectedness and complexity are underappreciated.  \nc Microvascular inflammation without donor-specific anti-HLA antibody did not independently worsen prognosis after adjustment for serial or concomitant T-cell–mediated rejection and de novo donor-specific anti-HLA antibody events in time-dependent models.  \nc HLA-DR/DQ alloimmune risk categories were multivariable correlates of microvascular inflammation–free survival, suggesting an association with HLA mismatch.  \nAbstract  \nBackground Microvascular inflammation (sum of glomerulitis [g] and peritubular capillaritis [ptc] scores $2) frequently occurs without donor-specific anti-HLA antibodies (DSAs), often alongside T-cell–mediated rejection (TCMR), yet its independent prognostic significance remains uncertain.  \nMethods In a consecutive single-center cohort of 689 kidney transplant recipients (2004–2021), we examined the impact of first g1ptc$2, TCMR, and de novo DSA (dnDSA) events on death-censored allograft loss using Cox models with timedependent covariates to account for event timing and overlap.  \nResults A first g1ptc$2 occurred in 106/689 (15%) recipients, and 88% had concomitant or sequential TCMR and/ordnDSA. Most g1ptc$2 biopsies were associated with TCMR (76%), including those with g50. When assessed individually, the first g1ptc$2 (hazard ratio [HR], 4.33; 95% confidence interval [CI], 2.5 to 7.5), TCMR (HR, 4.07; 95% CI, 2.3 to 7.1), and dnDSA (HR, 4.26; 95% CI, 2.2 to 8.3) events were each associated with death-censored allograft loss. However, in a combined time-dependent model, first TCMR (HR, 2.74; 95% CI, 1.4 to 5.4) and dnDSA (HR, 2.32; 95% CI, 1.1 to 5.1) remained independently associated with death-censored allograft loss, whereas g1ptc$2 did not (HR, 1.77; 95% CI, 0.84 to 3.73) .  \nConclusions In a modern tacrolimus-based cohort, g1ptc$2 without DSA was not associated with worse outcomes after adjustment for serial or concomitant TCMR and dnDSA events.  \nJASN 00: 1–9, 2026. doi: [https://doi.org/10.1681/ASN.0000001125](https://doi.org/10.1681/ASN.0000001125)  \nIntroduction  \nAntibody-mediated rejection (ABMR) is a leading cause of kidney allograft failure.1–3 However, the outcomes of microvascular inflammation, defined as the combination of Banff glomerulitis (g) and peritubular capillaritis (ptc) scores, in the absence of circulating donor-specific antiHLA antibody (DSA), remain inconsistent. The reported  \nprevalence of DSA-negative microvascular inflammation biopsies ranges from 14% to 59%, depending on immunologic risk, immunosuppression, and biopsy indication and timing.4–10 Senev et al. found that DSA-negative microvascular inflammation was transient, with allograft survival comparable with that of recipients without microvascular inflammation.4 Other groups have reported that recipients  \n1Department of Medicine, University of Manitoba, Winnipeg, Manitoba, Canada  \n2Department of Medicine, Yong Loo Lin School of Medicine, National University of Singapore, Singapore 3National University Centre for Organ Transplantation, National University Hospital, Singapore  \n4George and Fay Yee Centre for Healthcare Innovation, University of Manitoba, Winnipeg, Manitoba, Canada 5Shared Health Services Manitoba, Winnipeg, Manitoba, Canada  \n6Department of Pathology, University of Manitoba, Winnipeg, Manitoba, Canada  \n7Department of Pediatrics and Child Health, University of Manitoba, Winnipeg, Manitoba, Canada 8Department of Immunology, Universit","cbCaitHQ1kYUxl5m","https://ap.wps.com/l/cbCaitHQ1kYUxl5m","pdf",781403,"English","# Key Points\n# Abstract\n# Background\n# Methods\n# Results\n# Conclusions\n# Introduction","[{\"question\":\"How is microvascular inflammation defined in this study?\",\"answer\":\"Microvascular inflammation is defined as the sum of Banff glomerulitis (g) and peritubular capillaritis (ptc) scores, with g1ptc≥2 used for the primary first-event assessment.\"},{\"question\":\"What patient cohort and time span were analyzed?\",\"answer\":\"The study analyzed a consecutive single-center cohort of 689 kidney transplant recipients from 2004 to 2021.\"},{\"question\":\"Did microvascular inflammation without donor-specific anti-HLA antibodies worsen prognosis independently?\",\"answer\":\"No. In time-dependent combined models adjusting for serial or concomitant TCMR and de novo DSA events, microvascular inflammation without donor-specific anti-HLA antibody did not independently worsen death-censored allograft prognosis.\"}]","Microvascular Inflammation in Kidney Transplantation - Clinical Research | PDF",23]