Histological Characteristics of  Interstitial Renal Allograft Rejection

Nickeleit, Volker; Zeiler, Matthias; Gudat, F; Thiel, G; Mihatsch, Michael J.

doi:10.1159/000025862

Cited by 22 publications

(11 citation statements)

References 5 publications

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“…Following a positive BK urine or plasma result, testing was performed with increased frequency (every 1 – 2 weeks). BKN was diagnosed by the typical viral cytopathic changes in the epithelium of tubules, glomeruli, and/or collecting ducts, with nuclear positivity of epithelial cells by BKV-specific in situ hybridization as previously described (19). All cases of BKN showed pattern B histologic injury characterized by intense mononuclear inflammation with associated tubulitis.…”

Section: Patientsmentioning

confidence: 99%

Antirejection Treatment in Kidney Transplant Patients with BK Viruria

Kayler

Batal²,

Mohanka³

et al. 2008

Transplantation

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Background Kidney transplant recipients with BK virus nephropathy (BKN) or viremia are generally treated with reduction of immunosuppression to facilitate virus eradication. Methods Prompted by biopsy findings interpreted as acute rejection, we administered intravenous bolus steroids to 5 patients with BK virus in the plasma (BKP) (group 1) and also tried other anti-rejection therapies in 13 patients with BK virus in the urine (BKU) but no BKP (group 2). Results All group 1 patients had continued viremia, while 2 viruric patients in group 2 developed viremia following therapy. Ultimately, following reduced immunosuppression both groups cleared BKP over 53±29 days and 50±6 days, respectively. BKU clearance was not consistently observed. One year post-biopsy, there were no graft failures in group 1 (0%) and 2 (15%) in group 2; however, suboptimal renal function was observed in 40% and 62%, respectively (p=0.6). Conclusion Cautious anti-rejection treatment to patients with active BKP or BKU can lead to two possible outcomes (a) reduction in serum creatinine that is seemingly consistent with a diagnosis of acute rejection, and (b) lack of clinical response, which in the absence of overt BKN, makes it difficult to distinguish between refractory rejection and virus induced tissue inflammation.

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Section: Patientsmentioning

confidence: 99%

Antirejection Treatment in Kidney Transplant Patients with BK Viruria

Kayler

Batal²,

Mohanka³

et al. 2008

Transplantation

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“…Dendritic cells can produce IL-12 to activate naïve CD4 T cells (39,40). Co-stimulatory lymphocyte activation signals can also be provided by other cell types, such as tubular epithelial cells, by upregulation of MHC-class II, CD80, and CD86 (41)(42)(43)(44)(45)(46)..…”

Section: Non-classic Inflammatory Cells: Dendritic Cells Endothelialmentioning

confidence: 99%

Inflammatory cells in renal allografts

Nickeleit

Andreoni²

2008

Front Biosci

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Renal transplants are injured by a variety of diseases and pathways. One important cause for acute and chronic graft failure is rejection. Since the advent of kidney transplantation, it has become apparent that rejection is a cellular and/or antibody mediated inflammatory process with different histologic phenotypes, and clinical degrees of severity. In recent years, the immunohistochemical detection of the complement degradation product C4d has further helped to unravel mechanisms of graft injury. Our brief review of 'renal allograft inflammation' focuses on basic morphologic aspects of rejection. Our goal is to foster the close correlation between 'histologic variants of rejection/inflammation' and molecular signaling cascades including chemokine induced effects.

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“…The upregulation of MCH-class II (HLA-DR) and ICAM-1 on tubular epithelial cells is a typical finding in graft biopsies with cellular rejection and can serve as an adjunct diagnostic tool (Seron et al 1989;Nickeleit et al 1998). HLA-DR expression can stimulate an allogenic www.intechopen.com lymphocytic reaction and also enhance T cell mediated lysis (Rosenberg et al 1992).…”

Section: Interstitial Inflammationmentioning

confidence: 99%

Leflunomide an Immunosuppressive Drug for Antiviral Purpose in Treatment for BK Virus-Associated Nephropathy After Kidney Transplantation

Bazin¹

2012

Antiviral Drugs - Aspects of Clinical Use and Recent Advances

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Histological Characteristics of Interstitial Renal Allograft Rejection

Cited by 22 publications

References 5 publications

Antirejection Treatment in Kidney Transplant Patients with BK Viruria

Antirejection Treatment in Kidney Transplant Patients with BK Viruria

Inflammatory cells in renal allografts

Leflunomide an Immunosuppressive Drug for Antiviral Purpose in Treatment for BK Virus-Associated Nephropathy After Kidney Transplantation

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