{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,6,22]],"date-time":"2026-06-22T23:56:15Z","timestamp":1782172575197,"version":"3.54.5"},"reference-count":37,"publisher":"Wiley","issue":"3","license":[{"start":{"date-parts":[[2019,1,29]],"date-time":"2019-01-29T00:00:00Z","timestamp":1548720000000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Clinical Transplantation"],"published-print":{"date-parts":[[2019,3]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Background<\/jats:title><jats:p>We investigated clinical outcomes and molecular signatures of transplant glomerulopathy (TG) stratified by microvascular inflammation (MVI) and donor\u2010specific antibody (DSA) status.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>We performed a retrospective review of 749 kidney transplant patients who received a for\u2010cause kidney biopsy from 2009 to 2014. We classified TG as MVI positive (MVI+) or MVI negative (MVI\u2212), and with or without DSA. We obtained gene expression profiles for 44 biopsies by Affymetrix HuGene 1.0 ST expression arrays.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>A total of 100 patients had TG; 49 were MVI+, and 51 were MVI\u2212. After a median post\u2010biopsy follow\u2010up of 2.08\u00a0years (range 0.43\u20104.59), Kaplan\u2010Meier survival analysis demonstrated worse allograft survival in MVI+ TG patients compared with MVI\u2212 TG patients (<jats:italic>P<\/jats:italic>\u00a0=\u00a00.01), and time to graft failure was significantly shorter in MVI+ patients (1.08\u00a0\u00b1\u00a01.01\u00a0years vs 2.3\u00a0\u00b1\u00a01.8\u00a0years; <jats:italic>P<\/jats:italic>\u00a0=\u00a00.002). DSA status did not affect graft survival within MVI+ or MVI\u2212 groups. Analysis of pathogenesis\u2010based transcripts (PBT) showed that MVI+ TG biopsies had increased expression of gamma interferon and rejection (GRIT) and DSA\u2010associated transcripts (DSAST), as observed in antibody\u2010mediated rejection. MVI\u2212 TG biopsies had increased expression of cytotoxic and regulatory T cell\u2010 and B cell\u2010associated transcripts but not GRIT or DSAST. DSA status had no effect on expression of any PBTs studied in MVI\u2212 TG biopsies.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p>Graft survival in TG is significantly worse in the presence of MVI. Gene expression profiles of MVI+ TG resemble antibody\u2010mediated rejection while gene expression profiles of MVI\u2212 TG resemble cell\u2010mediated rejection regardless of DSA status.<\/jats:p><\/jats:sec>","DOI":"10.1111\/ctr.13469","type":"journal-article","created":{"date-parts":[[2018,12,22]],"date-time":"2018-12-22T16:49:02Z","timestamp":1545497342000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":11,"title":["Molecular signatures and clinical outcomes of transplant glomerulopathy stratified by microvascular inflammation and donor\u2010specific antibody"],"prefix":"10.1111","volume":"33","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-1076-7953","authenticated-orcid":false,"given":"Michelle","family":"Lubetzky","sequence":"first","affiliation":[{"name":"Weill Cornell\u2010NY Presbyterian Division of Nephrology  New York City New 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