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Cluster Analysis of Microvascular Inflammation in Indication Biopsies Unveils Distinct Pathological and Immunological Phenotypes with Prognostic Implications

J. Malheiro1, A. Silva1, S. Santos1, S. Tafulo2, L. Martins1, L. Dias1, A. Castro-Henriques1

1Centro Hospitalar do Porto, Porto, Portugal, 2IPST_Porto, Porto, Portugal

Meeting: 2019 American Transplant Congress

Abstract number: D98

Keywords: Alloantibodies, Histology, Rejection

Session Information

Session Name: Poster Session D: Kidney Acute Antibody Mediated Rejection

Session Type: Poster Session

Date: Tuesday, June 4, 2019

Session Time: 6:00pm-7:00pm

 Presentation Time: 6:00pm-7:00pm

Location: Hall C & D

*Purpose: We aimed to define distinct pathological and immunological clusters of 80 cases of MVI diagnosed in indication biopsies and evaluate their prognostic implications.

*Methods: The correlations between elementary histological lesions and DSA status were evaluated by Spearman correlation and clustering was performed based on the values of dissimilarities. Hence, 3 clusters were defined.

*Results:

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*Conclusions: The 3 clusters had clearly distinct phenotypes but similar graft function at biopsy. Importantly, significant stepwise differences in graft survival were detected. MVI cases occurring early post-transplant had a higher association of TCMR, with lower humoral injury scores and frequency of C1q-DSA (Cluster 1). Cluster 2 defined MVI cases with purer and stronger ABMR scores and more C1q-DSA detection. Finally, cluster 3 corresponded to late cases of caABMR, with incomplete phenotypes of rejection and an increase impact of non-adherence and de novo DSA emergence being noticeable.

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To cite this abstract in AMA style:

Malheiro J, Silva A, Santos S, Tafulo S, Martins L, Dias L, Castro-Henriques A. Cluster Analysis of Microvascular Inflammation in Indication Biopsies Unveils Distinct Pathological and Immunological Phenotypes with Prognostic Implications [abstract]. Am J Transplant. 2019; 19 (suppl 3). https://atcmeetingabstracts.com/abstract/cluster-analysis-of-microvascular-inflammation-in-indication-biopsies-unveils-distinct-pathological-and-immunological-phenotypes-with-prognostic-implications/. Accessed May 18, 2025.

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