Late allograft rejection

Question 1

What % of graft loss is associated with non compliance?

Answer 1

25%

Question 2

What is the predominant cause of late allograft loss?

Answer 2

Antibody mediated rejection

Question 3

What does a high KDPI indicate?

Answer 3

Worse outcome for transplant survival

Question 4

What term has replaced ‘Chronic allograft nephropathy’?

Answer 4

IFTA

Question 5

What is the goal tacrolimus level in stable transplant patients?

Answer 5

5-7

Question 6

What are the findings in CNI toxicity on renal biopsy?

Answer 6

• Striped fibrosis
• Tubular vacuolisation
• Art hyalinosis
• Endothelitis

Question 7

What are the conditions for switching a CNI to an mTOR?

Answer 7

• eGFR >40

- Proteinuria

Question 8

What is the principle contraindication to belatacept?

Answer 8

EBV - or EBV unknown

MGUS?

Question 9

What are the most common recurrent diseases in transplant patients?

Answer 9

1. MPGN (HR 2.9)
2. FSGS (HR 2)
3. IgA (100% after 20 years)

Question 10

What is the treatment for recurrent FSGS post-transplant?

Answer 10

Plasmapheresis

Question 11

What is transplant glomerulopathy (on histology)?

Answer 11

Expansion and duplication of the GBM

Question 12

C4d staining is required for the diagnosis of CAMR. True/False

Answer 12

False.

Question 13

What are the RF for CAMR?

Answer 13

1. 40-50% linked with non-compliance

2. HLA Class II Ab early (3 months) after transplant can predict CAMR if glomerulitis and capillaritis are present.