scholarly journals Glomerular Neovascularization in Nondiabetic Renal Allograft Is Associated with Calcineurin Inhibitor Toxicity

Nephron ◽  
2020 ◽  
pp. 1-6
Author(s):  
Anri Sawada ◽  
Masayoshi Okumi ◽  
Shigeru Horita ◽  
Kohei Unagami ◽  
Sekiko Taneda ◽  
...  
Keyword(s):  
Diabetic Kidney Disease ◽  
Renal Allograft ◽  
Calcineurin Inhibitor ◽  
Clinical Information ◽  
Renal Allografts ◽  
Biopsy Specimens ◽  
Allograft Biopsy ◽  
Time Periods ◽  
Medical University ◽  
Trough Levels

<b><i>Introduction:</i></b> Extra efferent arterioles, also known as polar vasculosis (PV), are often observed in the glomerular vascular pole and are associated with glomerular hypertrophy, indicating early recurrent diabetic kidney disease (DKD) in renal allografts. However, its significance in patients without diabetes remains uncertain. <b><i>Methods:</i></b> A total of 9,004 renal allograft biopsy specimens obtained between January 2007 and December 2017 at Tokyo Women’s Medical University were retrospectively analyzed to examine the clinical and pathological significance of PV in renal allografts. PV was identified in 186 biopsy specimens obtained from 165 patients. The PV group comprised 46 patients; 35 patients without DKD and 11 patients with DKD as the initial cause of ESRD, whose clinical information was available and treated with the calcineurin inhibitor (CNI) tacrolimus. The non-PV group comprising patients with renal allografts matched for age and postoperative day included 93 patients without DKD and 16 patients with DKD as the initial cause of ESRD. <b><i>Results:</i></b> In patients with nondiabetic renal allografts, systolic blood pressure was significantly higher in the PV group than in the non-PV group. The trough tacrolimus levels during the overall study period and at 2 weeks, 1 month, and 2 years after transplantation were significantly higher in the PV group compared with the non-PV group. Glomerulomegaly was significantly more common. Moreover, ah and aah scores in Banff score were significantly higher in the PV group than in the non-PV group. In those with diabetic renal allografts, although the clinical parameters and tacrolimus trough levels in all time periods were not significantly different between the PV and non-PV groups, the ah score was significantly higher in the PV group. <b><i>Conclusion:</i></b> PV was associated with CNI toxicity in nondiabetic but not in diabetic renal allografts. The pathogenesis of PV in renal allografts is considered to be multifactorial.

Detection of B Lymphocytes (CD20+) in Renal Allograft Biopsy Specimens

2007 ◽  
Vol 39 (2) ◽  
pp. 432-434 ◽  
Author(s):  
H.L. Martins ◽  
C. Silva ◽  
D. Martini ◽  
I.L. Noronha
Keyword(s):  
B Lymphocytes ◽  
Renal Allograft ◽  
Biopsy Specimens ◽  
Allograft Biopsy

scholarly journals Histopathological evaluation of renal allograft biopsies in Nepal: interpretation and significance

1970 ◽  
Vol 2 (3) ◽  
pp. 172-179
Author(s):  
G Aryal ◽  
DS Shah
Keyword(s):  
T Cell ◽  
Renal Allograft ◽  
Calcineurin Inhibitor ◽  
Viral Infections ◽  
Ischemic Injury ◽  
Graft Dysfunction ◽  
Post Transplant ◽  
Medical College ◽  
Antibody Mediated Rejection ◽  
Allograft Biopsy

Background:  Renal allograft biopsy remains the gold standard for the diagnosis of graft dysfunction. Protocol renal allograft biopsies have provided insights into pathogenesis of early and late allograft injury and guided clinical management. The aim of this study was to find out the causes of early and late graft dysfunction in renal allograft biopsies taken at different time points after transplantation. Materials and Methods: Between August 2008 and February 2011, a total of 98 renal allograft biopsies from 62 kidney transplants recipients were received in the department of Pathology, KIST Medical College and Teaching Hospital. Renal allograft biopsies were interpreted according to the Schemes of Banff ’09 update. Results: The maximum numbers of recipients were in the age group of 31-40 years. Age ranges from 16 to 61 years. Out of 62 recipients, there were 47(75.8%) males and 15 (24.2%) females. The time of biopsy ranges from 0 hour to 6 years after transplantation. There were 9 (9.18%) cases of acute T cell-mediated rejection, 8 (8.16%) cases of acute antibody-mediated rejection, 6 (6.12%) cases of acute ischemic injury, 6 (6.12%) cases of borderline lesions and 4 (4.08%) cases of chronic calcineurin inhibitor toxicity. Conclusion: In the early post-transplant period (0-6 months), acute antibody-mediated rejection, acute ischemic injury and T cell-mediated rejection are the major causes for graft dysfunction. In the late post transplant period (> 6 months after transplant), transplant glomerulopathy, chronic calcineurin inhibitor toxicity, viral infections and graft senescence including donor derived disease result in poor late graft survival.DOI: http://dx.doi.org/10.3126/jpn.v2i3.6016 JPN 2012; 2(3): 172-179

Histologic, ultrastructural, and immunomicroscopic findings in 96 one hour human renal allograft biopsy specimens

1980 ◽  
Vol 11 (2) ◽  
pp. 187-195 ◽  
Author(s):  
Rafael Valenzuela ◽  
Sammy A. Hamway ◽  
Sharad D. Deodhar ◽  
William E. Braun ◽  
Lynn H. Banowsky ◽  
...  
Keyword(s):  
Renal Allograft ◽  
Biopsy Specimens ◽  
Allograft Biopsy

scholarly journals Impact of specimen adequacy on the assessment of renal allograft biopsy specimens

2016 ◽  
Vol 49 (4) ◽  
Author(s):  
S. Cimen ◽  
L. Geldenhuys ◽  
S. Guler ◽  
A. Imamoglu ◽  
M. Molinari
Keyword(s):  
Renal Allograft ◽  
Biopsy Specimens ◽  
Allograft Biopsy

scholarly journals Clinical and Pathological Analyses of Borderline Changes Cases after Kidney Transplantation

Nephron ◽  
2020 ◽  
pp. 1-6
Author(s):  
Tomokazu Shimizu
Keyword(s):  
Renal Allograft ◽  
Interstitial Fibrosis ◽  
Graft Loss ◽  
Graft Function ◽  
Renal Transplant Recipients ◽  
Tubular Atrophy ◽  
Renal Graft ◽  
Interstitial Inflammation ◽  
Biopsy Specimens ◽  
Allograft Biopsy

<b><i>Aim:</i></b> We aimed to perform a clinicopathological analysis of cases presenting with borderline changes (BC) after renal transplantation and discuss whether BC might be clinically or pathologically important. <b><i>Materials and Methods:</i></b> BC was diagnosed in 22 renal allograft biopsy specimens obtained from 20 renal transplant recipients between April 2010 and March 2019 after follow-up at the Department of Transplant Surgery, Kidney Center, Toda Chuo General Hospital. <b><i>Results:</i></b> BC was diagnosed at a median of 500 days following transplantation. Among the 22 renal allograft biopsy specimens showing evidence of BC, tubulitis was observed in all specimens. Interstitial inflammation was present in 18 specimens (82%), peritubular capillaritis in 14 (64%), interstitial fibrosis (ci) and tubular atrophy (ct) in 4 (18%), and C4d deposition in the peritubular capillary was present in 6 specimens (27%). Glomerulitis and intimal arteritis were not observed. There was no renal graft loss during the observation period, but deterioration of renal allograft function after biopsy occurred in 9 patients (45%). <b><i>Conclusions:</i></b> In BC, tubulitis and interstitial inflammation were the main constituents. Because glomerulitis was not observed in our study, we suspect that BC contributes to acute T-cell-mediated rejection. Although BC did not lead to renal graft loss, renal graft function deterioration was seen in nearly half of the patients after the renal graft biopsy. We conclude that BC is important clinically and pathologically and needs to be monitored and treated appropriately.

scholarly journals Cholesterol emboli presenting as acute allograft dysfunction after renal transplantation.

1995 ◽  
Vol 6 (2) ◽  
pp. 165-170
Author(s):  
I Singh ◽  
P D Killen ◽  
A B Leichtman
Keyword(s):  
Renal Transplantation ◽  
Renal Transplant ◽  
Vascular Disease ◽  
Renal Allograft ◽  
Common Complication ◽  
Atherosclerotic Vascular Disease ◽  
Renal Allografts ◽  
Allograft Dysfunction ◽  
Allograft Biopsy ◽  
Cyclosporine Therapy

Cholesterol emboli are a common complication of atherosclerotic vascular disease. A 40-yr-old renal transplant recipient who developed acute allograft dysfunction 1 day after the initiation of cyclosporine therapy and 6 days after transplantation is described. A renal allograft biopsy revealed cholesterol emboli in interlobular arteries and in glomeruli. Four previously reported cases of cholesterol emboli in renal allografts are described, and the cause and pathogenesis of atheroembolic disease are reviewed. Atheroemboli causing injury to the renal allograft may arise from either donor or recipient vessels. Vigilance for the occurrence of these emboli needs to be maintained when donor or recipient vessels demonstrate evidence of significant atherosclerotic vascular disease.

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