Reversibility From Delayed Hyperacute Rejection in ABO-Incompatible Renal Transplantation: Histopathological Findings of Renal Allograft Biopsy

2005 ◽  
Vol 37 (2) ◽  
pp. 701-704
Author(s):  
K. Sugiyama ◽  
K. Arai ◽  
A. Aikawa ◽  
M. Miyagi ◽  
T. Ohara ◽  
...  
Keyword(s):  
Renal Transplantation ◽  
Renal Allograft ◽  
Hyperacute Rejection ◽  
Histopathological Findings ◽  
Allograft Biopsy

scholarly journals De novo Glomerular Disease and the Significance of Electron Microscopy in Renal Transplantation

2021 ◽  
pp. 1-13
Author(s):  
Surya V. Seshan ◽  
Steven P. Salvatore
Keyword(s):  
Electron Microscopy ◽  
Renal Transplantation ◽  
Renal Allograft ◽  
De Novo ◽  
Vascular Diseases ◽  
Prognostic Information ◽  
Glomerular Diseases ◽  
Allograft Biopsy ◽  
Transplant Kidney ◽  
Appropriate Therapy

<b><i>Background:</i></b> De novo glomerular diseases comprising those both common and unique to transplant may develop in the renal allograft leading to posttransplant proteinuria, hematuria, or allograft failure. Electron microscopy (EM) is a useful adjunct to the standard light and immunofluorescence microscopy for accurately diagnosing these diseases and subsequently aiding the clinician in initiating appropriate treatments. <b><i>Summary:</i></b> De novo diseases are those new-onset diseases in renal transplantation that are unrelated to the original kidney disease in the recipient. They include virtually any primary or secondary glomerular, tubulointerstitial, or vascular diseases, ranging from subclinical to clinically overt, having acute, subacute, or chronic clinical presentations. This review focuses on common or significant, mainly glomerular, entities, with particular attention to the EM findings. The time of onset, stage, and severity of these diseases may often be modified by the current immunosuppressive protocols and other donor and recipient predisposing characteristics. <b><i>Key Messages:</i></b> A renal allograft biopsy not only improves our understanding of the pathophysiology but also provides diagnostic accuracy prognostic information, and potential for reversibility. In some cases, the biopsy leads to detection of unsuspected or clinically asymptomatic de novo diseases in the setting of other concomitant rejection processes, infection, or toxicity, which can dictate appropriate therapy. Routine EM in transplant kidney biopsies is a valuable modality in recognizing fully developed or early/subtle features of evolving de novo diseases, often during the subclinical phases, in “for cause” or surveillance/protocol allograft biopsies.

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.

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.

scholarly journals Urolithiasis in renal transplantation: Diagnosis and management

2014 ◽  
Vol 86 (4) ◽  
pp. 257 ◽  
Author(s):  
Elisa Cicerello ◽  
Franco Merlo ◽  
Mario Mangano ◽  
Giandavide Cova ◽  
Luigi Maccatrozzo
Keyword(s):  
Renal Transplantation ◽  
Shock Wave Lithotripsy ◽  
Renal Allograft ◽  
Stone Formation ◽  
Urinary Calculi ◽  
The Other ◽  
Ureteral Stent ◽  
Nephrostomy Tube ◽  
Staghorn Calculus ◽  
Multimodal Management

Obiectives: To report our experience of diagnosis and multimodal management of urolithiasis in renal transplantation. Patients and Methods: From January 1995 to December 2012, 953 patients underwent renal transplantation in the Kidney Transplant Unit of Treviso General Hospital. Ten (10%) of them developed urinary calculi and were referred at our institution. Their mode of presentation, investigation and treatment were recorded. Results: Seven had renal and 3 ureteral calculi. Urolithiasis was incidentally discovered on routine ultrasound in 6 patients, 1 presented with oliguria, 1 with anuria and acute renal failure and in 2 urolithiasis was found at removal of the ureteral stent. Nephrostomy tube was placed in 5 patients. Hypercalcemia with hyperparathyroidism (HPT) was present in 5 patients and hyperuricemia in 3. Two patients were primary treated by shock wave lithotripsy (SWL) and one of them was stone-free after two sessions. Two patients, one with multiple pielocaliceal calculi and the other with staghorn calculus in the lower calyx, were treated with percutaneous nephrolitothotomy (PCNL). Three patients were treated by ureteroscopy (URS) and in one of them two treatments were carried out. One patient had calculus impacted in the uretero-vesical anastomosis and surgical ureterolithotomy with re-do ureterocystoneostomy was performed after failure of URS. Two patients with calculi discovered at removal of the ureteral stent were treated by URS. Conclusions: The incidence of urolithiasis in renal transplantation is uncommon. In the most of patients the condition occurs without pain. Metabolic anomalies and medical treatment after renal transplantation may cause stone formation. Advancements in endourology and interventional radiology have influenced the management of urolithiasis that can be actually treated with a minimal incidence of risk for the renal allograft.

scholarly journals Prognostic value for immediate function of one-hour renal allograft biopsy.

BMJ ◽  
1975 ◽  
Vol 4 (5996) ◽  
pp. 559-559 ◽  
Author(s):  
I W McDicken ◽  
K M Hawking ◽  
L D Lameyer ◽  
A P Blok ◽  
D L Westbroek
Keyword(s):  
Prognostic Value ◽  
Renal Allograft ◽  
Allograft Biopsy ◽  
Immediate Function

P1652IMPACT OF HEPATITIS C VIRUS AND DIRECT ACTING ANTIVIRALS ON JAPANESE RENAL ALLOGRAFT RECIPIENTS

2020 ◽  
Vol 35 (Supplement_3) ◽  
Author(s):  
Kazuaki Okino ◽  
Keita Yamazaki ◽  
Keiichiro Okada ◽  
Keiji Fujimoto ◽  
HIROKI ADACHI ◽  
...  
Keyword(s):  
Renal Transplantation ◽  
Renal Allograft ◽  
Patient Survival ◽  
Hcv Infection ◽  
Hcv Rna ◽  
Direct Acting Antivirals ◽  
Group A ◽  
Group B ◽  
Direct Acting ◽  
The Impact

Abstract Background and Aims The impact of hepatitis C virus (HCV) infection on patient survival after renal transplantation was worse. Previously, we found that continuous HCV infection was a significant independent risk factor for actuarial survival (especially at ≥20 years after the transplant procedure) among Japanese renal allograft recipients. This study evaluates the impact of HCV and of the new direct acting antivirals (DAAs) on patient outcomes in renal allograft recipients. Method We studied 46 cases (28 males, 18 females; 37 living-donor cases, 9 deceased-donor cases; mean follow-up period 305 months ranging from 2 to 420 months) out of the 315 renal transplanted patients who underwent the first renal transplantation in Kanazawa Medical University since 1974. They had antibodies against HCV: 11 were positive for HCV RNA and received DAAs (Group A, all of them genotype 1b); 27 were HCV RNA positive and did not receive any treatment (Group B); 8 were negative for HCV RNA (Group C) (Fig.1). Results All Group A patients had HCV RNA negativity after 2-12 weeks of treatment started, and 11 (100%) achieved a sustained virological response (SVR) at 24 weeks. All of them had no adverse effects by the use of DAAs. In this cohort, no patients in Group A died. On the other hand, 15 (55.5％) of 27 in Group B and 3 (37.5%) of 8 in Group C died. Causes of death among Group B were liver cirrhosis (5 cases), hepatocellular carcinoma (2 case), infections complicated with chronic hepatitis (6 cases) in chronic phase, fibrosing cholestatic hepatitis due to HCV (1 case) after surgery, and cardiovascular disease (1 case). The patient survival rate was significantly higher in Group A patients who received DAAs by Kaplan- Meier life table method (Log Rank test, Kay-square 11.7, p=0.004) (Fig.2). Conclusion Our results support the notion that continuous HCV infection was a harmful and that new DAAs were efficient and safe to treat HCV infection after renal transplantation.

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