Potential Utility of Neutrophil-to-Lymphocyte, Platelet-to-Lymphocyte, and Neutrophil, Lymphocyte, and Platelet Ratios in Differential Diagnosis of Kidney Transplant Acute Rejection: A Retrospective, Propensity Score Matched Analysis.

IF 1.1 4区 医学 Q3 SURGERY
Aureliusz Kolonko, Tomasz Dwulit, Michał Skrzypek, Andrzej Więcek
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引用次数: 0

Abstract

BACKGROUND Acute kidney transplant rejection can negatively affect long-term graft function. The neutrophil-to-lymphocyte ratio and platelet-to-lymphocyte ratio have been proposed as non-invasive predictors of acute rejection in stable kidney transplant recipients. The aim of this study was to validate the predictive value of these ratios, as well as neutrophil, lymphocyte, and platelet ratios in the diagnosis of acute rejection during the early post-transplant period. MATERIAL AND METHODS After propensity score matching, we compared 71 kidney recipients with biopsy-proven acute rejection with 71 patients without rejection and also subjects with different histologic types of rejection. All 3 types of blood cell count-derived ratios were calculated 6 and 3 days prior to biopsy and on the day of biopsy. RESULTS There were 15 patients with T cell-mediated rejection, 33 with vascular rejection, and 23 with antibody-mediated rejection. The values of all examined ratios did not differ between subgroups with and without rejection. However, at all post-transplant study time-points, patients with antibody-mediated rejection had significantly higher values of all analyzed ratios than subjects with other types of rejection. In multivariate regression models, higher values of blood cell count-derived ratios were independently associated with the occurrence of antibody-mediated rejection. CONCLUSIONS In the early post-transplant period, the values of neutrophil-to-lymphocyte, platelet-to-lymphocyte, and neutrophil, lymphocyte, and platelet ratios were similar in patients with and without an acute rejection episode, but significantly higher values were found in subjects with antibody-mediated rejection as compared with other types of rejection and those without rejection. High values of analyzed ratios in patients with satisfactory early kidney graft function may be helpful in selecting subjects with increased risk of subclinical antibody-mediated rejection.

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中性粒细胞对淋巴细胞、血小板对淋巴细胞、中性粒细胞、淋巴细胞和血小板比率在肾移植急性排斥反应鉴别诊断中的潜在效用:回顾性倾向评分匹配分析。
背景:急性肾移植排斥反应会对移植物的长期功能产生负面影响。中性粒细胞与淋巴细胞的比率和血小板与淋巴细胞的比率已被提出作为稳定肾移植受者急性排斥反应的非侵入性预测指标。本研究的目的是验证这些比率以及中性粒细胞、淋巴细胞和血小板比率在移植后早期诊断急性排斥反应中的预测价值。材料和方法经过倾向评分匹配后,我们比较了71例活检证实急性排斥反应的肾受体和71例无排斥反应的肾受体以及不同组织学类型的排斥反应的肾受体。在活检前6天和3天以及活检当天计算所有3种类型的血细胞计数衍生比率。结果T细胞性排斥反应15例,血管性排斥反应33例,抗体性排斥反应23例。所有检查的比率值在有排斥反应和没有排斥反应的亚组之间没有差异。然而,在移植后的所有研究时间点,抗体介导的排斥反应患者的所有分析比率值都明显高于其他类型排斥反应的受试者。在多元回归模型中,较高的血细胞计数衍生比率值与抗体介导的排斥反应的发生独立相关。结论:在移植后早期,有和没有急性排斥反应的患者的中性粒细胞对淋巴细胞、血小板对淋巴细胞、中性粒细胞、淋巴细胞和血小板比值相似,但抗体介导的排斥反应明显高于其他类型的排斥反应和没有排斥反应的患者。在早期肾移植功能令人满意的患者中,较高的分析比率值可能有助于选择亚临床抗体介导的排斥反应风险增加的受试者。
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来源期刊
CiteScore
2.50
自引率
0.00%
发文量
79
审稿时长
>12 weeks
期刊介绍: Annals of Transplantation is one of the fast-developing journals open to all scientists and fields of transplant medicine and related research. The journal is published quarterly and provides extensive coverage of the most important advances in transplantation. Using an electronic on-line submission and peer review tracking system, Annals of Transplantation is committed to rapid review and publication. The average time to first decision is around 3-4 weeks. Time to publication of accepted manuscripts continues to be shortened, with the Editorial team committed to a goal of 3 months from acceptance to publication. Expert reseachers and clinicians from around the world contribute original Articles, Review Papers, Case Reports and Special Reports in every pertinent specialty, providing a lot of arguments for discussion of exciting developments and controversies in the field.
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