Introduction. Assessing late histologic changes in renal allografts is important to investigating etiology and devising treatment. Compared to the usual semi-quantitative reading by a renal pathologist, more quantitative measurements might provide more accuracy and better reproducibility of important lesions. The goal of this study was to determine the correlation between pathologist's scoring and quantitative morphometry.

Methods. The pathologist, scored 20 10-year renal allograft surveillance biopsies using semi-quantitative Banff criteria (ah, ci, ct and cv). For quantitative analysis, the PAS and Trichrome stained slides were scanned into high resolution images, imported into software, and traced for luminal and intimal-media boundary of the largest and most orthogonal artery, and for contiguous areas of fibrosis with tubular atrophy. Using traced areas the percentage artery stenosis from intimal thickening (cv surrogate) and percent cortical fibrosis area (ci and ct surrogate) were calculated. The total number of arterioles with nodular and/or circumferential hyaline was recorded (ah surrogate). To compare the pathologist's scores to the quantitative measures, non-parametric Spearman's correlation was performed.

Results. Quantitative measures of cortical fibrosis area and arteriolar hyalinosis showed high correlation with ci, ct and ah scores read by the pathologist (p<0.01 for all; see table). Percent arterial intimal thickening did not associate with cv score (p=0.34) but was associated with most other pathologic scores (ci, ct, and ah, p<0.05 for all).

Conclusions. Quantitative measures showed high correlation with most chronic Banff scores. The poor correlation between % intimal thickening and cv score requires further exploration to identify the cause of the discrepancy. Quantitative measurements (performed by a technician) are a potential tool to complement renal pathology.

CITATION INFORMATION: Denic A, Smith B, Park W, Rule A, Cornell L, Stegall M. Quantitative Analysis of 10-Year Surveillance Renal Allograft Biopsies. Am J Transplant. 2017;17 (suppl 3).

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