Relationship between donor renal interstitial surface and post-transplant function

Abstract

Forty-three biopsies were performed between 30 and 60 min after reperfusion. Patients (22 males/21 females, mean age 41 +/- 12 years, mean donor age 32 +/- 14 years) were treated either with antilymphocytic globulin, cyclosporin, and prednisolone (24 cases), or OKT3, cyclosporin, and prednisolone (19 cases). Ten patients had delayed post-transplant renal function (DPRF), defined as haemodialysis requirements after surgery, and seven patients had acute rejection 11 +/- 16 days post-transplant. Kidneys were perfused with a hypertonic solution containing mannitol. All patients were followed up for at least 30 months. During follow-up, five patients lost their grafts due chronic rejection, two patients due to noncompliance and one due to recurrence of focal segmental glomerulosclerosis. One patient died from heart infarction. Biopsies were stained with H&E, Masson's trichrome, periodic acid-Schiff (PAS) and silver methenamine. Interstitial fibrosis, interstitial oedema, tubular vacuolization, and peritubular capillary oedema were measured using a semiquantitative scale. Five 400 x magnification micrographs of cortical interstitium from silver-methenamine-stained sections were used to measure percentage of interstitial surface with a morphometer. Interstitial surface was 18.7 +/- 6.2% (range 3.2-35.3%). A positive correlation was found between interstitial surface and donor age (r = 0.469, P = 0.0015). No relationship was found between warm and cold ischaemia times and tubular vacuolization or peritubular capillary oedema.(ABSTRACT TRUNCATED AT 250 WORDS)

Untreated Rejection in 6-Month Protocol Biopsies Is Not Associated with Fibrosis in Serial Biopsies or with Loss of Graft Function

“…Comparable to previous observations, donor age and fibrosis in the pretransplantation biopsy was associated with inferior graft function (29,30). Donor age or quality of the donor organ at implantation was not associated with a higher prevalence of SAR at 6 mo.…”

Serial Protocol Biopsies to Quantify the Progression of Chronic Transplant Nephropathy in Stable Renal Allografts

“…Although different morphometric approaches have shown that quantification of chronic renal damage in donor (13)(14)(15) and protocol biopsies (16)(17)(18) correlates with graft outcome, the utility of quantitative parameters as a primary efficacy variable in a hypothetical clinical trial aimed to modify the natural history of CAN has not been explored. Thus, the aim of the present study is to characterize the temporal evolution of intimal thickening and interstitial widening in stable grafts during the first year of follow-up using a morphometric approach.…”

Apports récents des techniques de quantification de la fibrose pour l’examen anatomopathologique en transplantation rénale

“…Nicholson et al ont développé une méthode semiquantitative pour mesurer la fibrose sur des sections biopsiques dont le marquage immunohistochimique reconnaît le collagène III [14]. D'autres ont mesuré le pourcentage de FI sur des sections de biopsies marquées par une solution d'argent-méthénamine par méthode morphomé-trique [15,16]. En effet, le collagène, les fibres de réti-culine ainsi que les muccopolysaccharides de la matrice extracellulaire sont marqués par la méthénamine.…”