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- Title
Histopathological and clinical findings in renal transplants with Banff type II and III acute cellular rejection without tubulointerstitial infiltrates.
- Authors
Bröcker, Verena; Hirzallah, Muhannad; Gwinner, Wilfried; Bockmeyer, Clemens; Wittig, Juliane; Zell, Stephanie; Agustian, Putri; Schwarz, Anke; Ganzenmüller, Tina; Zilian, Eva; Immenschuh, Stephan; Becker, Jan
- Abstract
According to the Banff guidelines for renal transplants, pure endothelialitis without any tubulointerstitial infiltrates (with the Banff components v ≥ 1, i0, t0) has to be called acute cellular rejection (ACR). The pathophysiology of this rare lesion abbreviated as v_only is currently unclear, as well as its clinical, serological, and prognostic implications. Therefore, we conducted this retrospective comparative study. We compared all 23 biopsies with v_only from Hannover Medical School between 2003 and 2010 with 23 matched biopsies with the Banff components v ≥ 1, i ≥ 1, and t ≥ 1 (v_plus) and 23 biopsies with v0, i0, and t0 (v0i0t0). Serological (available in 10, 11, and 14 patients, respectively), histological, and clinical data were compared. Of all biopsies, 0.4 % had findings of v_only. v_only, v_plus, and v0i0t0 only showed minimal differences in the Banff components apart from the cohort-defining components. Endothelialitis in v_only more frequently involved the arcuate arteries than the smaller preglomerular vessels compared to v_plus and vice versa. Combining histopathological data and serological data, v_only more frequently showed criteria for acute humoral rejection than v0i0t0 (albeit not persistent after the Bonferroni-Holm correction in pairwise comparisons), while there was no difference between v_only and v_plus. No difference could be demonstrated regarding clinical presentation at biopsy or outcome. Our results show minimal differences regarding clinical presentation, outcome, and histological features between v_only and v_plus. Patients with v_only should be thoroughly investigated for evidence of acute humoral rejection.
- Subjects
ENDARTERITIS; HISTOPATHOLOGY; ENDOTHELIOMA; PATHOLOGICAL physiology; TISSUE wounds; BIOPSY
- Publication
Virchows Archiv: European Journal of Pathology, 2014, Vol 464, Issue 2, p203
- ISSN
0945-6317
- Publication type
Article
- DOI
10.1007/s00428-013-1487-0