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https://www.readbyqxmd.com/read/30119615/individual-histologic-lesions-and-composite-scores-in-implant-biopsies-affect-short-term-and-long-term-kidney-allograft-function
#1
Andriy V Trailin, Tamara N Nykonenko, Tetyana I Ostapenko, Sergiy R Vildanov, Olexandr S Nykonenko
OBJECTIVES: Our aim was to evaluate which histologic lesions in a donor kidney were associated with graft function up to 5 years and with its dynamics. MATERIALS AND METHODS: We retrospectively investigated the association between acute and chronic individual histologic lesions and composite scores in preimplant and postreperfusion biopsies from deceased-donor (n = 101) and living-donor (n = 29) kidneys with initial graft function and function at discharge, at 6 months, and at 5 years and slopes of estimated glomerular filtration rate from discharge to 6 months and from 6 months to 5 years...
August 17, 2018: Experimental and Clinical Transplantation
https://www.readbyqxmd.com/read/30053273/an-integrative-approach-for-the-assessment-of-peritubular-capillaritis-extent-and-score-in-low-grade-microvascular-inflammation-associations-with-transplant-glomerulopathy-and-graft-loss
#2
Nicolas Kozakowski, Harald Herkner, Farsad Eskandary, Michael Eder, Wolfgang Winnicki, Johannes Kläger, Gregor Bond, Željko Kikic
Background: Peritubular capillaritis (ptc), reported by the ptc score, is a major feature of kidney allograft rejection and microvascular inflammation (MVI). MVI sum scores (ptc + glomerulitis score ≥2) are accepted diagnostic surrogates of human leucocyte antigen (HLA)-antibody interaction. However, low-grade inflammation is common and ptc scores (number of leucocytes/capillary) may not mirror all aspects of ptc morphology. Recently we observed a relationship of the diffuse extent of ptc (inflammation of >50% of the renal cortex) with graft loss and significantly higher donor-specific antibody levels, suggesting potential inclusion of diffuse ptc as an additional surrogate of antibody-antigen interaction...
July 20, 2018: Nephrology, Dialysis, Transplantation
https://www.readbyqxmd.com/read/30022978/mouse-model-established-by-early-renal-transplantation-after-skin-allograft-sensitization-mimics-clinical-antibody-mediated-rejection
#3
Daqiang Zhao, Tao Liao, Siwen Li, Yannan Zhang, Haofeng Zheng, Jing Zhou, Fei Han, Yu Dong, Qiquan Sun
Antibody-mediated rejection (AMR) is the main barrier to renal graft survival, and mouse renal AMR models are important to study this process. Current mouse models are established by priming the recipient to donor skin for over 7 days before kidney transplantation. The robustness of AMR in these cases is too strong to mimic clinical AMR and it is unclear why altering the priming times ranging from 7 to 91 days fails to reduce the AMR potency in these models. In the present study, we found that the donor-recipient combination and skin graft size were determinants of donor-specific antibody (DSA) development patterns after skin transplantation...
2018: Frontiers in Immunology
https://www.readbyqxmd.com/read/29968416/cell-mediated-rejection-revisited-past-current-and-future-directions
#4
REVIEW
Shigeo Hara
The Banff histopathology classification system is the gold standard for assessing the causes of kidney allograft dysfunction triggered by antibody-mediated and T-cell-mediated immune reactions, thereby providing mechanistic insight and guiding therapeutic decisions. The original Banff classification (1993) consisted of four histological categories representing cell-mediated rejection: interstitial inflammation (i), tubulitis (t), endoarteritis (v), and transplant glomerulitis (g). The revised Banff 2007 classification added total inflammation score (ti) from both scarred and unscarred areas based on evolving interpretations of interstitial infiltrates...
July 2018: Nephrology
https://www.readbyqxmd.com/read/29968414/clinicopathological-features-and-outcomes-of-kidney-allografts-in-plasma-cell-rich-acute-rejection-a-case-series
#5
Aki Mafune Hamada, Izumi Yamamoto, Mayuko Kawabe, Haruki Katsumata, Takafumi Yamakawa, Ai Katsuma, Yasuyuki Nakada, Akimitsu Kobayashi, Yusuke Koike, Jun Miki, Hiroki Yamada, Takahiro Kimura, Yudo Tanno, Ichiro Ohkido, Nobuo Tsuboi, Hiroyasu Yamamoto, Takashi Yokoo
Plasma cell-rich acute rejection (PCAR) is a rare type of acute rejection in renal transplantation. Despite aggressive immunotherapy, approximately 40-60% of patients develop graft loss within 1 year after an episode of PCAR. However, the reason for this outcome remains obscure. This study retrospectively identified six patients with PCAR diagnosed between 2009 and 2015 at a single university hospital. Clinicopathological data were collected. Five of the six patients were male, and mean age at the onset of PCAR was 49...
July 2018: Nephrology
https://www.readbyqxmd.com/read/29968403/protocol-graft-biopsy-in-kidney-transplantation
#6
REVIEW
Ken Sakai, Hideyo Oguchi, Masaki Muramatsu, Seiichiro Shishido
Accurate interpretation of renal allograft biopsy is necessary to guide therapy, especially when an episode biopsy is taken to rescue the graft. Contrarily, a protocol biopsy is carried out routinely to identify baseline conditions (biopsy at 0 or 1 h), subclinical rejection, histological change under current immunosuppression regimen, drug nephrotoxicity, viral infection, and recurrence of glomerulonephritis. Semiquantitative scoring for active lesions including tubulitis, glomerulitis, capillaritis, arteritis, arteriopathy, and others such as polyomavirus infection are key factors in transplant pathology...
July 2018: Nephrology
https://www.readbyqxmd.com/read/29860655/protective-effects-of-amifostine-curcumin-and-melatonin-against-cisplatin-induced-acute-kidney-injury
#7
Filiz Mercantepe, Tolga Mercantepe, Atilla Topcu, Adnan Yılmaz, Levent Tumkaya
Despite the enormous advances made in the field of oncology, no solution to the side effect of nephrotoxicity caused by cisplatin used as an antineoplastic agent for approximately 40 years has yet been discovered. This study investigated the effects of cisplatin on the kidney, the damage mechanism involved, and the potential capacity of agents such as amifostine, curcumin, and melatonin to elicit a future therapeutic protocol in cisplatin-induced nephrotoxicity at the ultrastructural and molecular levels. Our study consisted of five groups: control (saline solution only; group 1), cisplatin (cisplatin only; group 2), cisplatin + amifostine (group 3), cisplatin + curcumin (group 4), and cisplatin + melatonin (group 5)...
June 2, 2018: Naunyn-Schmiedeberg's Archives of Pharmacology
https://www.readbyqxmd.com/read/29801667/complement-binding-anti-hla-antibodies-are-independent-predictors-of-response-to-treatment-in-kidney-recipients-with-antibody-mediated-rejection
#8
Denis Viglietti, Yassine Bouatou, Vissal David Kheav, Olivier Aubert, Caroline Suberbielle-Boissel, Denis Glotz, Christophe Legendre, Jean-Luc Taupin, Adriana Zeevi, Alexandre Loupy, Carmen Lefaucheur
A major hurdle to improving clinical care in the field of kidney transplantation is the lack of biomarkers of the response to antibody-mediated rejection (ABMR) treatment. To discover these we investigated the value of complement-binding donor-specific anti-HLA antibodies (DSAs) for evaluating the response to treatment. The study encompassed a prospective cohort of 139 kidney recipients with ABMR receiving the standard of care treatment, including plasma exchange, intravenous immunoglobulin and rituximab. Patients were systematically assessed at the time of diagnosis and three months after treatment initiation for clinical and allograft histological characteristics and anti-HLA DSAs, including their C1q-binding ability...
May 22, 2018: Kidney International
https://www.readbyqxmd.com/read/29731056/clinical-significance-of-macrophage-polarization-in-antibody-mediated-rejection-of-renal-allograft
#9
J Kim, S-E Choi, B J Lim, Y S Kim, K H Huh, J Lee, S I Kim, M S Kim, H J Jeong
BACKGROUND: The significance of proinflammatory M1 (classically activated) and profibrotic M2 (alternatively activated) macrophages in antibody-mediated rejection (ABMR) after kidney transplantation has not been investigated. METHODS: Fifty-five biopsy-confirmed ABMR samples were stained with MRP 8/14 (a marker of M1 macrophages) and CD163 (a marker of M2 macrophages), and positive cells were counted in glomeruli and the tubulointerstitium, respectively. Patients were classified into M1 and M2 polarization groups according to the glomerular and tubulointerstitial M1:M2 ratio, and the results were compared with Banff scores, serum creatinine level, estimated glomerular filtration rate (eGFR), and graft survival...
May 2018: Transplantation Proceedings
https://www.readbyqxmd.com/read/29724319/-clinicopathological-features-and-treatment-of-renal-impair-in-primary-sj%C3%A3-gren-syndrome
#10
Jing Wang, Li Meng Chen
Primary Sjögren syndrome,characterized by autoimmune epithelitis,is a prevalent systemic autoimmune disease involving multiple organs,among which kidney is a major target organ.Tubulointerstitial lesion is the most frequent form,involving proximal tubule,distal tubule,or collecting duct.The disease has an occult onset and may progressively develop into renal function impairment and end-stage renal disease,which can be accompanied with low-molecular-weight proteinuria,renal tubule acidosis and electrolyte disturbance...
April 28, 2018: Zhongguo Yi Xue Ke Xue Yuan Xue Bao. Acta Academiae Medicinae Sinicae
https://www.readbyqxmd.com/read/29709950/an-autopsy-case-of-myeloperoxidase-anti-neutrophil-cytoplasmic-antibody-mpo-anca-associated-vasculitis-accompanied-by-cryoglobulinemic-vasculitis-affecting-the-kidneys-skin-and-gastrointestinal-tract
#11
Jumpei Hasegawa, Sachiko Wakai, Momoko Kono, Yusuke Imaizumi, Sakiko Masuda, Akihiro Ishizu, Kazuho Honda
Anti-neutrophil cytoplasmic antibody (ANCA) -associated vasculitis (AAV) and cryoglobulinemic vasculitis (CV) rarely coexist. An 83-year-old woman was admitted with rapidly progressive renal failure, gastrointestinal hemorrhage and purpura with myeloperoxidase (MPO) -ANCA positivity and cryoglobulinemia. Despite intensive immunosuppressive treatment, she died of aspergillus pneumonia. Autopsy revealed necrotizing crescentic glomerulitis in the majority of the glomeruli, accompanied by partially membranoproliferative-like glomerular changes...
April 27, 2018: Internal Medicine
https://www.readbyqxmd.com/read/29602372/-the-pathology-of-renal-transplants
#12
Eduardo Vazquez Martul
In order to make an objective assessment of the histopathology of a renal biopsy during a kidney transplant, all the various elements involved in the process must be understood. It is important to know the characteristics of the donor organ, especially if the donor is older than 65. The histopathological features of the donor biopsy, especially its vascular status, are often related to an initial poor function of the transplanted kidney. The T lymphocyte inflammatory response is characteristic in acute cellular rejection; the degree of tubulitis, together with the amount of affected parenchyme, are important factors...
April 2018: Revista Española de Patología
https://www.readbyqxmd.com/read/29582530/safety-and-utility-of-surveillance-biopsies-in-pediatric-kidney-transplant-patients
#13
Maritere Nazario, Oana Nicoara, Lauren Becton, Sally Self, Jeanne Hill, Elizabeth Mack, Melissa Evans, Katherine Twombley
There is currently no way to diagnose a rejection before a change in serum creatinine. This had led some to start doing SB, but little data exist on the utility and safety of SB in pediatric patients. There is also little known on practice patterns of pediatric nephrologists. A retrospective review of pediatric kidney transplant SB between January 2013 and January 2017 at a single center was performed. A survey went to the PedNeph email list. There were 47 SB; 15 at 6 months, 12 at 1 year, 13 at 2 years, and 7 at 3 years...
June 2018: Pediatric Transplantation
https://www.readbyqxmd.com/read/29536028/rituximab-and-monitoring-strategies-for-late-antibody-mediated-rejection-after-kidney-transplantation
#14
Sandesh Parajuli, Didier A Mandelbrot, Brenda Muth, Maha Mohamed, Neetika Garg, Fahad Aziz, Robert R Redfield, Weixiong Zhong, Brad C Astor, Arjang Djamali
Background: There is limited information on treatment strategies and monitoring strategies for late antibody-mediated rejection (ABMR) after kidney transplantation. Methods: In this observational and nonrandomized study, we compared 78 patients diagnosed with late ABMR (>3 months after transplant) who were treated with standard of care steroids/IVIG (n = 38) ± rituximab (n = 40) at our center between March 1, 2013 and December 31, 2016. All patients had follow-up biopsy and donor-specific antibodies (DSA) monitoring within 3 to 12 weeks...
December 2017: Transplantation Direct
https://www.readbyqxmd.com/read/29507276/classification-of-acute-rejection-episodes-in-kidney-transplantation-a-proposal-based-on-factor-analysis
#15
Francisco E Rodríguez Castellanos, Francisco Domínguez Quintana, Virgilia Soto Abraham, Eduardo Mancilla Urrea
INTRODUCTION: Kidney transplantation is considered the ideal treatment for end-stage renal disease. Acute rejection can influence graft survival. The aim of this study was to propose a classification system for acute rejection based on factor analysis. MATERIALS AND METHODS: Data were collected from kidney transplant recipients with acute rejection diagnosis based on standard histological variables, the presence of peritubular eosinophils, and immunolabeling for lysozyme and myeloperoxidase in kidney tissue...
March 2018: Iranian Journal of Kidney Diseases
https://www.readbyqxmd.com/read/29300203/evolving-criteria-for-the-diagnosis-of-antibody-mediated-rejection-in-renal-allografts
#16
Mark Haas
PURPOSE OF REVIEW: To review changes in the Banff schema for antibody-mediated renal allograft rejection over the past decade, including key revisions agreed upon during and immediately subsequent to the 2017 Banff Conference on Allograft Pathology. RECENT FINDINGS: The original Banff schema for diagnosis of acute and chronic active antibody-mediated rejection (ABMR) in renal allografts was formulated at the 2001 and 2007 Banff Conferences, and required histologic (primarily microvascular inflammation and transplant glomerulopathy), immunohistologic (C4d in peritubular capillaries), and serologic [circulating donor-specific antibodies (DSA)] evidence for a definitive diagnosis of ABMR...
May 2018: Current Opinion in Nephrology and Hypertension
https://www.readbyqxmd.com/read/29297490/prostate-cancer-diagnostic-criteria-and-role-of-immunohistochemistry
#17
Cristina Magi-Galluzzi
The diagnosis of prostate cancer is based on microscopic criteria. Presently, prostate needle biopsy interpretation can be a challenge for the pathologist due to the increased number of specimens with limited amount of suspicious glands and minimal atypia. It is critical for the pathologist to have an organized methodical approach when considering the morphological features enabling a definitive diagnosis of prostate cancer. Although several diagnostic criteria and supportive features have been advocated, only few findings are absolutely specific and diagnostic of prostate cancer...
January 2018: Modern Pathology: An Official Journal of the United States and Canadian Academy of Pathology, Inc
https://www.readbyqxmd.com/read/29277923/expression-of-programmed-death-ligand-1-on-bladder-tissues-is-detected-in-a-clinically-and-histologically-well-defined-interstitial-cystitis-cohort
#18
Yuke Chen, Wei Yu, Yang Yang, Yunxiang Xiao, Yun Cui, Jihong Duan, Qun He, Jie Jin, Shiliang Wu
OBJECTIVE: To investigate the expression of programmed death ligand-1 (PD-L1) in interstitial cystitis (IC). METHODS: We reviewed the data of IC patients underwent hydrodistension plus bladder biopsy. Follow-ups were performed. We assessed the degree of inflammation of the bladder wall on slides stained with hematoxylin and eosin (H&E). We performed immunohistochemistry for PD-L1 expression detection and for counting T lymphocytes and B lymphocytes. RESULTS: The present study included eight men and 32 women...
April 2018: Neurourology and Urodynamics
https://www.readbyqxmd.com/read/29215459/complete-b-cell-deficiency-reduces-allograft-inflammation-and-intragraft-macrophages-in-a-rat-kidney-transplant-model
#19
Sarah E Panzer, Nancy A Wilson, Bret M Verhoven, Ding Xiang, C Dustin Rubinstein, Robert R Redfield, Weixiong Zhong, Shannon R Reese
BACKGROUND: Increasingly, it is being appreciated that B cells have broad roles beyond the humoral response and are able to contribute to and regulate inflammation. The specific role of B cells in the pathogenesis of early allograft inflammation remains unclear. METHODS: To address this question, we generated B cell-deficient (B) Lewis rats via clustered regularly interspaced short palindromic repeats (CRISPR) technology. In a full mismatch transplant model, kidneys from Brown Norway donors were transplanted into B Lewis recipients or wild type Lewis recipients...
March 2018: Transplantation
https://www.readbyqxmd.com/read/29159992/clinical-and-histopathologic-features-of-antibody-mediated-rejection-among-pediatric-renal-transplant-recipients-with-preformed-vs-de-novo-donor-specific-antibodies
#20
COMPARATIVE STUDY
Justin A Steggerda, Irene K Kim, Mark Haas, Xiaohai Zhang, Alexis Kang, Helen Pizzo, Elaine Kamil, Stanley Jordan, Dechu Puliyanda
Preformed and de novo donor specific antibodies (pDSA and dnDSA) are risk factors for ABMR. This study compares the effects of pDSA vs dnDSA in pediatric kidney transplant recipients. Sixteen pediatric patients with biopsy-proven ABMR were evaluated. Strong DSA (MFI >10 000) was recorded at transplant, rejection, and follow-up. DSAs with the highest MFI were termed iDSAs. Allograft biopsies were scored according to Banff 2013 criteria. Seven of 16 (44%) patients had pDSA at transplant; 9 (56%) developed dnDSA...
December 2017: Pediatric Transplantation
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