Interstitial Fibrosis Is the Critical Determinant of Impaired Renal Function in Transplant Glomerulopathy
1Urology, Tokyo Women's Medical University, Tokyo, Japan
2Pathology, Tokyo Women's Medical University, Tokyo, Japan
3Pathology, Tama Hospital, Kanagawa, Japan.
Meeting: 2015 American Transplant Congress
Abstract number: B117
Keywords: Antibodies, Glomerular filtration rate (GFR), Graft function, Renal dysfunction
Session Information
Session Name: Poster Session B: Kidney Complications: Late Graft Failure
Session Type: Poster Session
Date: Sunday, May 3, 2015
Session Time: 5:30pm-6:30pm
Presentation Time: 5:30pm-6:30pm
Location: Exhibit Hall E
PURPOSE: Transplant glomerulopathy (TGP) represents chronic antibody-mediated injury in the glomerular capillaries after renal transplantation, and is the main cause of graft failure. TGP is usually accompanied by renal impairment; however, it may also be identified with stable renal function. This study examined the morphological features contributing to renal dysfunction in transplant recipients diagnosed with TGP.
METHODS: A total of 3602 renal transplant biopsies were performed on 871 renal transplant patients of Tokyo Women's Medical University between 2005 and 2013. Among these, TGP was diagnosed in 127 (3.5%) biopsy samples obtained from 59 (6.7%) recipients. Renal function and proteinuria were evaluated using the estimated glomerular filtration rate (eGFR) and dipstick tests, respectively.
RESULTS: The proportion of Banff grade of TGP was as follows; cg1 : n = 72 (56.7%), cg2: n = 37 (29.1%), cg3: n = 18 (14.2%). The eGFR was significantly worse with a higher degree of interstitial fibrosis (ci) at the time of biopsy (p < 0.0001)
; however, none of the Banff scores such as TGP (cg), microvascular inflammation (g+ptc), interstitial inflammation (i), and C4d were correlated with eGFR. Proteinuria was correlated to the severity of TGP (cg) (p = 0.0003), irrespective of the ci score.
CONCLUSIONS: Although the severity of TGP was significantly associated with proteinuria, TGP itself did not contribute to renal dysfunction. In addition, interstitial fibrosis was the only determinant of impaired renal function in patients diagnosed with TGP at the time of biopsy.
To cite this abstract in AMA style:
Toki D, Ishida H, Okumi M, Shimizu T, Shirakawa H, Inui M, Omoto K, Unagami K, Kanzawa T, Honda K, Koike J, Tanabe K. Interstitial Fibrosis Is the Critical Determinant of Impaired Renal Function in Transplant Glomerulopathy [abstract]. Am J Transplant. 2015; 15 (suppl 3). https://atcmeetingabstracts.com/abstract/interstitial-fibrosis-is-the-critical-determinant-of-impaired-renal-function-in-transplant-glomerulopathy/. Accessed November 21, 2024.« Back to 2015 American Transplant Congress