Medullary nephritis in the diagnosis of acute cellular rejection

Visoná, Iria; Sementilli, Ângelo; Kuschnaroff, L. M.; Franco, Marcello

doi:10.1016/j.prp.2015.07.008

Cited by 3 publications

(5 citation statements)

References 20 publications

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“…In the study by Bonsib et al [ 1 ], inflammatory responses in the cortex were more pronounced than those in the medulla, but the rejection intensity was similar. Although related to acute cellular rejection, Visona et al [ 3 ] reported that rejection should still be considered in renal allograft biopsies that present with tubulointerstitial inflammation exclusively in the medulla. As such, both the medulla and cortex need to be evaluated during the diagnosis of allograft rejection.…”

Section: Discussionmentioning

confidence: 99%

“…It has been suggested that renal allograft biopsies presenting with tubulointerstitial inflammation exclusively in the medulla could be considered a sign of rejection. Visona et al [ 3 ] reported that evidence of tubulointerstitial inflammation in the medulla should be considered as a surrogate marker of acute cellular rejection. Cases of AMR confined to medullary lesions are rare.…”

Section: Introductionmentioning

confidence: 99%

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Acute antibody-mediated rejection limited to medullary lesions in following ABO-incompatible living donor kidney transplantation

Kim

Cho

Park

et al. 2021

Korean Journal of Transplantation

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Anatomical differences between the renal cortex and medulla may influence inflammatory responses. Owing to the difficulty in diagnosing rejections from the medulla, rejection is usually diagnosed through the cortex. However, previous studies have shown that there are no significant differences in renal cortical and medullary lesions in acute allograft rejection. A 60-year-old man with a history of diabetic nephropathy underwent kidney transplant from a living unrelated donor at our hospital in August 2019. Three days after surgery, his urine output suddenly decreased, whereas the serum creatinine levels increased. A kidney biopsy showed only medullary lesions with positive C4d-staining and a Banff score of PTC grade 3. He was diagnosed with acute antibody-mediated rejection (AMR) and treatment was initiated. He did not respond to conventional treatments, including plasma exchange and intravenous immunoglobulin, but his general condition improved after bortezomib administration. There have been a few cases of acute AMR limited to medullary lesions. We consider that rejection cannot be excluded even if the lesions are confined to the medulla.

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Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Acute antibody-mediated rejection limited to medullary lesions in following ABO-incompatible living donor kidney transplantation

Kim

Cho

Park

et al. 2021

Korean Journal of Transplantation

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“…Visona et al [ 27 ] investigated the role of lymphomononuclear inflammation (nephritis) in kidney transplants and were involved in the analysis of 113 kidney-transplant biopsies.…”

Section: Extraction Of Rna and Clinical Markers From Histological Sam...mentioning

confidence: 99%

“…A common finding among these studies was the importance of T-cell mediated rejection (TCMR) and antibody-mediated rejection (ABMR) in acute rejection [ 16 , 17 , 19 , 20 , 21 , 26 ]. Several studies identified the biomarker CD4+ CD25+/CD39+ expression to predict acute cellular rejection (ACR) as well [ 23 , 24 , 27 ]. The studies also highlighted the importance of detecting and treating acute rejection, as it was found to increase the risk of graft loss [ 15 , 31 ].…”

Section: Extraction Of Rna and Clinical Markers From Histological Sam...mentioning

confidence: 99%

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Biomarkers for Kidney-Transplant Rejection: A Short Review Study

Sharaby,

Alksas,

Abou El-Ghar

et al. 2023

Biomedicines

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Kidney transplantation is the preferred treatment for end-stage renal failure, but the limited availability of donors and the risk of immune rejection pose significant challenges. Early detection of acute renal rejection is a critical step to increasing the lifespan of the transplanted kidney. Investigating the clinical, genetic, and histopathological markers correlated to acute renal rejection, as well as finding noninvasive markers for early detection, is urgently needed. It is also crucial to identify which markers are associated with different types of acute renal rejection to manage treatment effectively. This short review summarizes recent studies that investigated various markers, including genomics, histopathology, and clinical markers, to differentiate between different types of acute kidney rejection. Our review identifies the markers that can aid in the early detection of acute renal rejection, potentially leading to better treatment and prognosis for renal-transplant patients.

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