Transplant glomerulopathy: clinico-pathologic features
Transplant glomerulopathy is a sign of chronic kidney allograft damage. It has a distinct morphology and is associated with poor allograft survival. We aimed to assess the prevalence and clinic-pathologic features of transplant glomerulopathy, as well as determine the functional and histological implications of its severity. We performed a single-centre retrospective observational study during an eight-year period. Kidney allograft biopsies were diagnosed and scored according to the Banff classification, coupled with immunofluorescence studies. The epidemiology, clinical presentation, outcomes (patient and graft survival) and anti-HLA alloantibodies were evaluated. Transplant glomerulopathy was diagnosed in 60 kidney transplant biopsies performed for clinical reasons in 49 patients with ABO compatible renal transplant and a negative T-cell complement dependent cytotoxicity crossmatch at transplantation. The estimated prevalence of transplant glomerulopathy was 7.4% and its cumulative prevalence increased over time. C4d staining in peritubular capillaries (27.6%) was lower than the frequency of anti-HLA antibodies (72.5%), the majority against both classes I and II. Transplant glomerulopathy was associated with both acute (mainly glomerulitis and peritubular capillaritis) and chronic histologic abnormalities. At diagnosis, 30% had mild, 23.3% moderate and 46.7% severe transplant glomerulopathy. The severity of transplant glomerulopathy was associated with the severity of interstitial fibrosis. Other histological features, as well as clinical manifestations and graft survival, were unrelated to transplant glomerulopathy severity
Main Authors: | , , , , , , , , , |
---|---|
Format: | Digital revista |
Language: | English |
Published: |
Sociedade Portuguesa de Nefrologia
2013
|
Online Access: | http://scielo.pt/scielo.php?script=sci_arttext&pid=S0872-01692013000300010 |
Tags: |
Add Tag
No Tags, Be the first to tag this record!
|
id |
oai:scielo:S0872-01692013000300010 |
---|---|
record_format |
ojs |
spelling |
oai:scielo:S0872-016920130003000102014-01-28Transplant glomerulopathy: clinico-pathologic featuresSilva,CristinaCotovio,PatriciaMarques,MariaAfonso,NunoSancho,Maria RosarioCarvalho,FernandaTrindade,HelderCarreira,ArmandoCampos,MarioNolasco,Fernando Antibody glomerulopathy histology kidney transplant Transplant glomerulopathy is a sign of chronic kidney allograft damage. It has a distinct morphology and is associated with poor allograft survival. We aimed to assess the prevalence and clinic-pathologic features of transplant glomerulopathy, as well as determine the functional and histological implications of its severity. We performed a single-centre retrospective observational study during an eight-year period. Kidney allograft biopsies were diagnosed and scored according to the Banff classification, coupled with immunofluorescence studies. The epidemiology, clinical presentation, outcomes (patient and graft survival) and anti-HLA alloantibodies were evaluated. Transplant glomerulopathy was diagnosed in 60 kidney transplant biopsies performed for clinical reasons in 49 patients with ABO compatible renal transplant and a negative T-cell complement dependent cytotoxicity crossmatch at transplantation. The estimated prevalence of transplant glomerulopathy was 7.4% and its cumulative prevalence increased over time. C4d staining in peritubular capillaries (27.6%) was lower than the frequency of anti-HLA antibodies (72.5%), the majority against both classes I and II. Transplant glomerulopathy was associated with both acute (mainly glomerulitis and peritubular capillaritis) and chronic histologic abnormalities. At diagnosis, 30% had mild, 23.3% moderate and 46.7% severe transplant glomerulopathy. The severity of transplant glomerulopathy was associated with the severity of interstitial fibrosis. Other histological features, as well as clinical manifestations and graft survival, were unrelated to transplant glomerulopathy severityinfo:eu-repo/semantics/openAccessSociedade Portuguesa de NefrologiaPortuguese Journal of Nephrology & Hypertension v.27 n.3 20132013-09-01info:eu-repo/semantics/articletext/htmlhttp://scielo.pt/scielo.php?script=sci_arttext&pid=S0872-01692013000300010en |
institution |
SCIELO |
collection |
OJS |
country |
Portugal |
countrycode |
PT |
component |
Revista |
access |
En linea |
databasecode |
rev-scielo-pt |
tag |
revista |
region |
Europa del Sur |
libraryname |
SciELO |
language |
English |
format |
Digital |
author |
Silva,Cristina Cotovio,Patricia Marques,Maria Afonso,Nuno Sancho,Maria Rosario Carvalho,Fernanda Trindade,Helder Carreira,Armando Campos,Mario Nolasco,Fernando |
spellingShingle |
Silva,Cristina Cotovio,Patricia Marques,Maria Afonso,Nuno Sancho,Maria Rosario Carvalho,Fernanda Trindade,Helder Carreira,Armando Campos,Mario Nolasco,Fernando Transplant glomerulopathy: clinico-pathologic features |
author_facet |
Silva,Cristina Cotovio,Patricia Marques,Maria Afonso,Nuno Sancho,Maria Rosario Carvalho,Fernanda Trindade,Helder Carreira,Armando Campos,Mario Nolasco,Fernando |
author_sort |
Silva,Cristina |
title |
Transplant glomerulopathy: clinico-pathologic features |
title_short |
Transplant glomerulopathy: clinico-pathologic features |
title_full |
Transplant glomerulopathy: clinico-pathologic features |
title_fullStr |
Transplant glomerulopathy: clinico-pathologic features |
title_full_unstemmed |
Transplant glomerulopathy: clinico-pathologic features |
title_sort |
transplant glomerulopathy: clinico-pathologic features |
description |
Transplant glomerulopathy is a sign of chronic kidney allograft damage. It has a distinct morphology and is associated with poor allograft survival. We aimed to assess the prevalence and clinic-pathologic features of transplant glomerulopathy, as well as determine the functional and histological implications of its severity. We performed a single-centre retrospective observational study during an eight-year period. Kidney allograft biopsies were diagnosed and scored according to the Banff classification, coupled with immunofluorescence studies. The epidemiology, clinical presentation, outcomes (patient and graft survival) and anti-HLA alloantibodies were evaluated. Transplant glomerulopathy was diagnosed in 60 kidney transplant biopsies performed for clinical reasons in 49 patients with ABO compatible renal transplant and a negative T-cell complement dependent cytotoxicity crossmatch at transplantation. The estimated prevalence of transplant glomerulopathy was 7.4% and its cumulative prevalence increased over time. C4d staining in peritubular capillaries (27.6%) was lower than the frequency of anti-HLA antibodies (72.5%), the majority against both classes I and II. Transplant glomerulopathy was associated with both acute (mainly glomerulitis and peritubular capillaritis) and chronic histologic abnormalities. At diagnosis, 30% had mild, 23.3% moderate and 46.7% severe transplant glomerulopathy. The severity of transplant glomerulopathy was associated with the severity of interstitial fibrosis. Other histological features, as well as clinical manifestations and graft survival, were unrelated to transplant glomerulopathy severity |
publisher |
Sociedade Portuguesa de Nefrologia |
publishDate |
2013 |
url |
http://scielo.pt/scielo.php?script=sci_arttext&pid=S0872-01692013000300010 |
work_keys_str_mv |
AT silvacristina transplantglomerulopathyclinicopathologicfeatures AT cotoviopatricia transplantglomerulopathyclinicopathologicfeatures AT marquesmaria transplantglomerulopathyclinicopathologicfeatures AT afonsonuno transplantglomerulopathyclinicopathologicfeatures AT sanchomariarosario transplantglomerulopathyclinicopathologicfeatures AT carvalhofernanda transplantglomerulopathyclinicopathologicfeatures AT trindadehelder transplantglomerulopathyclinicopathologicfeatures AT carreiraarmando transplantglomerulopathyclinicopathologicfeatures AT camposmario transplantglomerulopathyclinicopathologicfeatures AT nolascofernando transplantglomerulopathyclinicopathologicfeatures |
_version_ |
1756001664966328320 |