Digital Kidney Biopsy Evaluation: Quantification of Macrophage Prevalence in a Cross Sectional Study.
1Institute of Pathology, Hannover Medical School, Hannover, Germany
2Department of Nephrology and Hypertension, Hannover Medical School, Hannover, Germany.
Meeting: 2016 American Transplant Congress
Abstract number: D6
Keywords: Histology, Image analysis, Kidney transplantation, Mononuclear leukocytes
Session Information
Session Name: Poster Session D: Antibody Mediated Rejection: Session #2
Session Type: Poster Session
Date: Tuesday, June 14, 2016
Session Time: 6:00pm-7:00pm
Presentation Time: 6:00pm-7:00pm
Location: Halls C&D
Standardized markers based on quantitative and qualitative evaluation of immune cell mass and localization in kidney biopsies may help in diagnosis and prognosis in transplantation medicine.
Kidney biopsies from 472 patients (mean age 50.8 years, range 2-86 years) were stained for macrophages using a monoclonal CD68 antibody (clone PGM1), subsequentielly scanned (Leica) and analyzed as whole slide images for immunopositively stained area using a digital approach (Definiens Tissue Studio). Results were obtained separately for cortex, medulla and extrarenal tissue. 72% of cases were kidney transplant (KTx) biopsies.
CD68-positively immunostained area (% of the respective cortex, medulla and extrarenal area) was generally increased in KTx vs. non-KTx biopsies (cortex: p<0.001; medulla: p<0.001; extrarenal: p<0.001). 40% of the studied KTx revealed rejection (humoral 7%, cellular 24%, mixed cellular and humoral 9%). Humoral rejection was associated with increased macrophage infiltration compared to all other entities (cortex: humoral vs. no rejection, p=0.005, humoral vs. cellular, p=0.001; medulla: humoral vs. no rejection, p<0.001, humoral vs. cellular, p<0.001) which was also consistent if pure humoral and additionally mixed rejections were tested against no and cellular rejection (cortex p<0.001, medulla p<0.001). Macrophage content increased over time: The highest values were measured in cortex and medulla when post transplant time exceeded 1 year (compared to <1year and >90 days, <90 days and >8 days, as well as <8 days, p<0.001), congruent with fibrotic changes.
Macrophages essentielly participate in active rejection and chronic allograft injury. Digital morphological approaches may contribute to understanding allograft pathophysiology and prognosticating long term graft outcome.
CITATION INFORMATION: Schmitz J, Khalifa A, Haller H, Kreipe H, Feuerhake F, Bräsen J. Digital Kidney Biopsy Evaluation: Quantification of Macrophage Prevalence in a Cross Sectional Study. Am J Transplant. 2016;16 (suppl 3).
To cite this abstract in AMA style:
Schmitz J, Khalifa A, Haller H, Kreipe H, Feuerhake F, Bräsen J. Digital Kidney Biopsy Evaluation: Quantification of Macrophage Prevalence in a Cross Sectional Study. [abstract]. Am J Transplant. 2016; 16 (suppl 3). https://atcmeetingabstracts.com/abstract/digital-kidney-biopsy-evaluation-quantification-of-macrophage-prevalence-in-a-cross-sectional-study/. Accessed May 20, 2025.« Back to 2016 American Transplant Congress