Donor Derived Cell Free DNA Kinetics Post Kidney Transplant Biopsy

Background:Donor-derived cell-free DNA (dd-cfDNA) has generated interest as a biomarker for kidney transplant (KT) rejection. It is possible that the KT biopsy procedure can cause the release of dd-cfDNA, therefore affecting the reliability of this assay in the post biopsy period. In this study we evaluated the effect of KT biopsy on the kinetics of dd-cfDNA.Methods:We conducted a single arm prospective study. Samples were collected from 16 adult KT recipients undergoing KT biopsy. All participants had samples drawn within eight hours prior to the biopsy (pre-biopsy), within 20 minutes (hour 0), 2 hours (hour 2), and 24-48 hours (hours 24-48) after the biopsy. We evaluated the change in dd-cfDNA from the pre-biopsy time point to the following 3 time points after the biopsy.Results:At hour 0 and hour 2, there was a significantly larger log dd-cfDNA mean score compared to the pre-biopsy score [Least square mean (LSM) estimate 0.4 (0.17, 0.63) and 0.39 (0.09, 0.68) respectively]. By 24-28 hours post biopsy there was no significant difference in log dd-cfDNA mean score compared to the pre-biopsy score [LSM estimate -0.21 (-0.6, 0.19)]. Conclusion:KT biopsy leads to an increase in dd-cfDNA after the procedure, however, this rise is transient and resolves by 24-48 hour after the biopsy. Providers can obtain dd-cfDNA level as soon as 48 hours post biopsy with high confidence that the levels have not been affected by the biopsy. In addition, our findings suggest possible non-traditional reasons for increase in dd-cfDNA such as mechanical reasons.

P1683INFLUENCE OF BIOPSY PROGNOSIS ON GRAFT SURVIVAL

Background and Aims Renal transplantation is the best alternative renal replacement option for patients with advanced chronic kidney disease. However, the supply of young donors is limited, and does not cover the demand of patients on the renal transplant waiting list, for this reason are being used older donors and exists a high discard rate of those organs base on pathological results (score) of the preimplant renal biopsy. There are several methods to evaluate the quality of the kidneys and the Kidney Donor Profile Index (KDPI) has acquired special relevance to decide the perform of preimplant renal biopsy. Based on the score, a preimplant renal biopsy is performed, which is decisive in certain cases. However, there is poor evidence to support this decision, which can be described as “conservative,” since there is not enough certainty that there is influence of the preimplant biopsy score score on graft survival. Method 389 biopsies of kidney transplant donors of cadaver donors in brain death and asystole type III were included. Donors in asystole type II, combined and live, were excluded. Samples examined by the same pathologist and in paraffin (no case by freezing). A graft survival analysis was performed based on the results of the renal biopsy (score). Likewise, a multivariate analysis of graft survival was carried out including, in addition to the results of the renal biopsy, results such as the age of the donor and recipient and the KDPI. Results graft survival was compared between two transplant subpopulations in our hospital based on whether a preimplant biopsy was performed. According to the data used there are no significant differences in graft survival between transplants in which biopsy has been performed and those that have not. Conclusion our work shows, as is currently the case in the literature, the absence of influence on the score of the preimplant biopsy score on graft survival.

Aspek Histopatologik Adenokarsinoma Prostat

<p><strong>Introduction: </strong>Prostate carcinoma is the second most common tumor in male, 95% in which made up from adenocarcinoma. The diagnosis of prostate adenocarcinoma through a needle biopsy specimen plus the determination of tumor staging are paramount in selecting the therapy and management. This study is done to know the morphologic variation of prostate adenocarcinoma in the needle biopsy as well as to measure the grading compatibility between the needle biopsy and prostatectomy using Gleason scoring system.</p><p><strong>Materials and Method: </strong>This retrospective study is conducted through form and specimen slides compilement. The specimens, consisting of prostate adenocarcinoma’s needle biopsy and prostatectomy, were gathered from the archives of Pathological Anatomy Departement, Faculty of Medicine, University of Indonesia in the year of 2008-2013. The slides were re-read and the morphologic appearance’s variation was valued. Gleason scoring was also executed from the pairing specimen according to <em>International Society of Urological Pathology</em> (ISUP) 2010.</p><p><strong>Result: </strong>Out of 114 needle biopsy cases, the morphologic variation was found to be perineural invation (n=38), mucinous fibroplasia (n=1), glomerulation (n=1), mucinous basophilic (n=25), and eosinophilic crystal (n=5). The amount of patient that was performed both specimen is 11, and there is a compatibility between biopsy score and prostatectomy as much as 63.63% and the median is 7.</p><p><strong>Conclusion: </strong>It is requisite to know the morphological variation in prostate adenocarcinoma in the biopsy needle specimen to get an accurate diagnosis. Undergrading in biopsy specimen is as much as 36.36%, owing to the fact that prostate carcinoma can be manifested as mutifocal lesion, thus the higher grading can only be found in prostatectomy specimen, for the needle biopsy was inadequately taken.</p><p><strong>Keywords: prostate adenocarcinoma, morphological view, Gleason score</strong></p>

Relationship between uterine biopsy score, endometrial infection and inflammation in the mare

Summary Objective: Endometrial biopsy score is an accepted marker of uterine health and predicted fertility, and it has been suggested that endometrial alternations are correlated with susceptibility to persistent infectious endometritis. The objective of this study was to investigate associations of endometrial biopsy score with: 1) presence of polymorphonuclear cells (PMNs) in the epithelium and stratum compactum in histopathology; 2) presence of PMNs in cytology and 3) presence of infection in microbiology. Materials and methods: The material for examination was collected from 69 mares suspected for subclinical endometritis (bred three or more times unsuccessfully in the same breeding season) and from 15 maiden mares. Samples were collected by endometrial biopsy and cytobrush technique. Results: Endometrial alterations (biopsy score IIA, IIB, III) were found in 64 of 82 mares (78%). There was an increase in PMN occurrence for grades IIA, IIB and III. When comparing grades and PMNs infiltration, we observed statistically significant differences between grades I and IIA (p = 0.222) and grades I and IIB (p = 0.042) in samples collected by endometrial biopsy. Statistically significant differences were found in microbiological examination (biopsy p = 0.036; cytobrush p = 0.189), cytological examination (biopsy p = 0.040; cytobrush p = 0.079) and PMN infiltration (p = 0.042) between mares with biopsy scores I and IIB. Furthermore, the highest percentage of infected mares was in grade IIA and IIB, and we found statistically significant differences between grades I and IIA (p = 0.043), and grades I and IIB (p = 0.036) in biopsy samples. We observed a tendency to higher prevalence of endometrial infection in mares with biopsy score IIA, IIB and III than with biopsy score I in samples collected using cytobrush technique. However, there were no statistical significant differences. Conclusion: Degenerative endometrial changes can predispose to uterine infection and inflammation. Our study shows that mares with endometrial score I are less predisposed to infection than mares with category IIA, IIB and III. Endometrial biopsy is a reliable diagnostic tool.