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Updated: Jun 26, 2026
18:48
In Vitro and In Vivo Assessment of T, B and Myeloid Cells Suppressive Activity and Humoral Responses from Transplant Recipients
Published on: August 12, 2017
Ahmedabad tolerance induction protocol and chronic renal allograft dysfunction: pathologic observations and clinical
Rashmi D Patel1, Aruna V Vanikar, Feroz A Aziz
1Department of Pathology, Laboratory Medicine, Transfusion Services and Immunohematology, G.R. Doshi and K.M. Mehta Institute of Kidney Diseases, Ahmedabad, India. rashmi381@yahoo.co.in
Diagnostic Pathology
|February 3, 2009
Summary
The Ahmedabad Tolerance Induction Protocol (ATIP) with hematopoietic stem cell transplantation (HSCT) reduced chronic immune injury in renal allografts. However, ATIP was associated with increased chronic calcineurin inhibitor toxicity.
Area of Science:
- Nephrology
- Immunology
- Transplantation
Background:
- Chronic Renal Allograft Dysfunction (CRAD) significantly contributes to graft loss.
- Acute T-cell rejections can be prevented with the Ahmedabad Tolerance Induction Protocol (ATIP) combined with hematopoietic stem cell transplantation (HSCT).
- B-cell mediated rejections and CRAD remain challenges post-transplantation.
Purpose of the Study:
- To retrospectively analyze renal allograft biopsies over four years.
- To evaluate the efficacy of ATIP in mitigating Chronic Renal Allograft Dysfunction (CRAD).
Main Methods:
- Comparison of two groups: ATIP with low-dose immunosuppression and HSCT versus controls receiving standard triple-drug immunosuppression.
- Analysis of renal allograft biopsies using modified Banff criteria.
- Demographic data showed comparable groups.
Main Results:
- Lower incidence of chronic changes in the ATIP group (10.98%) compared to controls (17.5%).
- Reduced proteinuria, hypertension, chronic transplant glomerulopathy, focal global sclerosis, and C4d deposits in the ATIP group.
- Higher incidence of acute on chronic calcineurin inhibitor toxicity observed in the ATIP group (71.9%) versus controls (48.4%).
Conclusions:
- ATIP demonstrates a potential to reduce chronic immune injury in renal allografts.
- Increased chronic calcineurin inhibitor toxicity is a notable side effect of ATIP requiring further investigation.
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