scholarly journals Clinicopathologic Relevance of Vascular Changes Associated with Transplant Glomerulopathy Secondary to Chronic Antibody-mediated Rejection in the Renal Allograft

2018 ◽  
Author(s):  
Deján Dobi
Keyword(s):  
Renal Allograft ◽  
Vascular Changes ◽  
Antibody Mediated Rejection ◽  
Transplant Glomerulopathy

scholarly journals Transplant Glomerulopathy: Importance of Ultrastructural Examination

2021 ◽  
pp. 1-14
Author(s):  
Ian W. Gibson
Keyword(s):  
Renal Allograft ◽  
Early Stage ◽  
Diagnostic Feature ◽  
Hepatitis C Infection ◽  
Ultrastructural Examination ◽  
Diagnostic Features ◽  
Antibody Mediated Rejection ◽  
Morphologic Alteration ◽  
Donor Specific Antibodies ◽  
Transplant Glomerulopathy

<b><i>Background:</i></b> Transplant glomerulopathy (TG) is a morphologic alteration in glomeruli of renal allografts, characterized by glomerular basement membrane reduplications. <b><i>Summary:</i></b> TG is associated with progressive chronic allograft dysfunction and proteinuria and is a diagnostic feature of chronic antibody-mediated rejection (ABMR) in patients positive for donor-specific antibodies, according to the Banff schema for renal allograft pathology. It is a definitive endpoint in clinical trials and interventional studies for ABMR, but the lesion can also occur in the absence of definitive alloimmune injury, as a consequence of chronic thrombotic microangiopathy, and in some cases in association with hepatitis C infection. This review discusses the pathophysiology and clinical presentation of TG, the diagnostic features by light microscopy, and focuses on the sequential ultrastructural stages of the lesion. The differential diagnosis of TG, and Banff grading of the lesion, are reviewed. Clinicopathological indications for performing routine ultrastructural examination of renal allograft biopsies are discussed. <b><i>Key Messages:</i></b> TG can be diagnosed at an early stage by electron microscopy, before histological features are apparent, emphasizing the importance of ultrastructural examination of renal allograft biopsies for an early diagnosis, when therapeutic intervention may be beneficial.

scholarly journals B Cell Activating Factor, Renal Allograft Antibody-Mediated Rejection, and Long-Term Outcome

2018 ◽  
Vol 2018 ◽  
pp. 1-5 ◽  
Author(s):  
Haiyan Xu ◽  
Xiaozhou He ◽  
Renfang Xu
Keyword(s):  
B Cell ◽  
Renal Allograft ◽  
Delayed Diagnosis ◽  
Clinical Manifestations ◽  
Direct Proof ◽  
Term Outcome ◽  
Long Term Outcome ◽  
Antibody Mediated Rejection ◽  
B Cell Activating Factor

Antibody-mediated rejection (ABMR) of renal allograft lacks typical phenotypes and clinical manifestations, always resulting in delayed diagnosis and treatment. It has been considered to be an elemental factor influencing the improvement of the long-term outcome of renal allograft. The B cell activating factor (BAFF) signal plays a fundamental function in the process of antibody-mediated immune response. Data from recipients and the nonhuman primate ABMR model suggest that the BAFF signal participates in the ABMR of renal allograft, while there are objections. The challenges in the diagnosis of ABMR, different study population, and details of research may explain the discrepancy. Large quantities of dynamic, credible data of BAFF ligands and their association with renal allograft pathological characteristics would constitute a direct proof of the role of BAFF in the progression of renal allograft ABMR.

scholarly journals Banff lesions and renal allograft survival in chronic-active antibody mediated rejection

2019 ◽  
Vol 56 ◽  
pp. 101213 ◽  
Author(s):  
Kasia A. Sablik ◽  
Marian C. Clahsen- van Groningen ◽  
Jeffrey Damman ◽  
Dave L. Roelen ◽  
Michiel G.H. Betjes
Keyword(s):  
Renal Allograft ◽  
Allograft Survival ◽  
Antibody Mediated Rejection

scholarly journals Late Renal Allograft Rupture Associated with Cessation of Immunosuppression following Graft Failure

2011 ◽  
Vol 2011 ◽  
pp. 1-5 ◽  
Author(s):  
Sumayah Askandarani ◽  
Noura Aloudah ◽  
Hanan Al Enazi ◽  
Khaled O. Alsaad ◽  
Abdulrahman Altamimi
Keyword(s):  
Graft Failure ◽  
Unusual Case ◽  
Renal Allograft ◽  
Time Interval ◽  
Antibody Mediated Rejection ◽  
Immunosuppressive Medications ◽  
Peritubular Capillaries ◽  
Long Time ◽  
Cellular Rejection ◽  
Marked Drop

A 29-year-old man developed chronic allograft nephropathy 63 months after renal transplantation. He became symptomatic with advanced chronic graft failure; his immunosuppressive medications were reduced and he was commenced on haemodialysis. Two months following the withdrawal of immunosuppression, he presented with abdominal pain, haematuria, and a marked drop in haemoglobin. The patient was taken to the operating room, where the renal allograft was found to be ruptured, and graft nephrectomy was subsequently performed. Histological examination of the graft specimen showed severe haemorrhagic acute vascular cellular rejection in a background of marked chronic allograft vasculopathy. Immunostaining for C4d showed diffuse, strong, linear circumferential staining of the peritubular capillaries, indicating a concurrent antibody-mediated rejection. We report herein an unusual case of spontaneous renal allograft rupture that occurred long time after transplantation due to severe acute rejection following cessation of immunosuppressive medications for advanced chronic allograft failure. To the best of our knowledge, the time interval between transplantation and the rupture of this allograft is the longest of those reported in the literature.

scholarly journals De NovoFibrillary Glomerulonephritis (FGN) in a Renal Transplant with Chronic Hepatitis C

2013 ◽  
Vol 2013 ◽  
pp. 1-5 ◽  
Author(s):  
Edward J. Filippone ◽  
Christine Chmielewski ◽  
Rakesh Gulati ◽  
Eric Newman ◽  
John L. Farber
Keyword(s):  
Chronic Hepatitis ◽  
Hepatitis C ◽  
Renal Transplant ◽  
Chronic Hepatitis C ◽  
Renal Transplant Patient ◽  
Renal Allograft ◽  
De Novo ◽  
First Case ◽  
Transplant Glomerulopathy

Chronic hepatitis C viremia (HepC) has been associated with numerous renal manifestations both in native kidneys and in the setting of renal transplantation. Glomerulonephritis (GN) of the renal allograft in the setting of HepC most commonly manifests as type 1 membranoproliferative GN (MPGN), either representing recurrence of the original disease or arisingde novo. Other GNs were reported after transplantation in the patient with HepC including membranous nephropathy and thrombotic microangiopathy, as well as an enhanced susceptibility to transplant glomerulopathy. We describe the first case ofde novofibrillary GN in a renal transplant patient with HepC where the primary renal disease was biopsy proven type 1 MPGN. We discuss this relationship in detail.

Clinical Significance of Macrophage Polarization in Antibody-Mediated Rejection of Renal Allograft

2018 ◽  
Vol 50 (4) ◽  
pp. 1005-1008 ◽  
Author(s):  
J. Kim ◽  
S.-E. Choi ◽  
B.J. Lim ◽  
Y.S. Kim ◽  
K.H. Huh ◽  
...  
Keyword(s):  
Clinical Significance ◽  
Renal Allograft ◽  
Macrophage Polarization ◽  
Antibody Mediated Rejection
Sign in / Sign up

Export Citation Format

Share Document