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:

*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.

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 July 2, 2025.

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