{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,13]],"date-time":"2026-08-13T05:29:02Z","timestamp":1786598942219,"version":"build-2736575974"},"reference-count":25,"publisher":"Frontiers Media SA","license":[{"start":{"date-parts":[[2026,8,13]],"date-time":"2026-08-13T00:00:00Z","timestamp":1786579200000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"DOI":"10.13039\/100007797","name":"Helsingin Yliopisto","doi-asserted-by":"publisher","id":[{"id":"10.13039\/100007797","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["frontierspartnerships.org"],"crossmark-restriction":true},"short-container-title":["Transpl. Int."],"abstract":"<jats:p>Treatment resistant acute rejection after kidney transplantation is linked to inferior outcomes, yet many centers do not routinely perform follow-up biopsies. The optimal timing of such biopsies remains uncertain. We evaluated findings from follow-up biopsies performed \u226445 days after treatment of acute rejection and assessed their association with long-term outcomes. Adult kidney transplants performed from 01\/2014 to 07\/2024 were included (n = 2,420). Acute rejections were classified according to Banff criteria. T-cell\u2013mediated rejection, including borderline TCMR changes, was treated with pulse steroids; antibody-mediated rejection was treated with steroids, intravenous immunoglobulin, and plasma exchange. Findings from follow-up biopsies taken \u226445 days after treatment of early acute rejection were correlated with graft outcomes. Of 383 patients (16%) with acute rejection within 3 months post-transplant, 221 underwent a follow-up biopsy \u226445 days. Of these, 50% were taken by protocol and 50% because of clinical reasons. In 164 cases (74%), rejection changes had resolved. At 1-year, median creatinine was 1.3\u00a0mg\/dL in those without rejection, 1.6\u00a0mg\/dL in patients with persistent changes, and 1.5\u00a0mg\/dL in those with resolved changes. Persistent histologic rejection within 45 days was associated with inferior long-term graft survival.<\/jats:p>","DOI":"10.3389\/ti.2026.16296","type":"journal-article","created":{"date-parts":[[2026,8,13]],"date-time":"2026-08-13T05:10:11Z","timestamp":1786597811000},"update-policy":"https:\/\/doi.org\/10.3389\/crossmark-policy","source":"Crossref","is-referenced-by-count":0,"title":["Findings and significance of early follow-up biopsies after treatment of acute rejection in kidney transplant recipients"],"prefix":"10.3389","volume":"39","author":[{"given":"Amanda","family":"Ahlmark","sequence":"first","affiliation":[{"name":"Department of Transplantation and Liver Surgery, Helsinki University Hospital and University of Helsinki","place":["Helsinki, Finland"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kaisa","family":"Ahopelto","sequence":"additional","affiliation":[{"name":"Department of Transplantation and Liver Surgery, Helsinki University Hospital and 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