The morphological compensatory change of peritubular capillary network in chronic allograft rejection

Abstract

To clarify the compensatory hemodynamic alterations in the interstitium of renal allograft biopsies with chronic rejection, we evaluated the morphological changes in the peritubular capillary (PTC) network. Seven renal biopsy specimens from recipients with chronic rejection presenting with elevation of serum creatinine of 1.9 +/- 0.5 mg/dL were examined. Renal biopsy specimens from their counterpart donors were used as normal controls. In each specimen, non-pathological interstitial areas without fibrosis, tubular atrophy or cell infiltration were compared with pathological areas (PA) showing fibrosis and/or tubular atrophy using a computer image analysis. Morphological measurements revealed that the mean cut surface area of the PTC in the non-pathological and pathological interstitial areas in the recipient biopsies were significantly larger than that of the normal controls (p < 0.001 and 0.001, respectively). In the recipient biopsies, both of the mean cut surface areas of the tubules and PTC in the non-pathological areas were significantly higher than those in the PA (p < 0.001). The mean glomerular diameter in the recipient biopsies was also significantly higher than that of the donors (p < 0.01). In this study, we provided pathological evidence for the compensatory interstitial and glomerular hemodynamic alterations in kidney graft with chronic rejection and the condition as single kidney.

The Landscape of Digital Pathology in Transplantation: From the Beginning to the Virtual E-Slide

“…Most of the studies on graft kidney biopsy use DIA techniques to explore the role of several biopsy features ranging from fibrosis evaluated with special stains to the expression and quantification of specific IHC markers in determining organ outcome,[68697071727374757677787980818283] as well as signs of acute rejection. [84858687888990919293] In all of these studies, there is no direct comparison of DIA evaluation with manual pathologist results. Moreover, most of these are retrospective or case–control observational studies.…”

Microvascular rarefaction and hypertension in the impaired recovery and progression of kidney disease following AKI in preexisting CKD states

“…One possibility is altered mechanical forces within peritubular capillaries. CKD is associated with hypertension, impaired renal blood flow (RBF) autoregulation (12), endothelial dysfunction (72), inflammation (1), and increased peritubular capillary size and pressure (3,15,25,34,52). In conjunction with increased endothelial permeability and damage after AKI (5,11,63,64), altered mechanical forces within peritubular capillaries could negatively impact cells that regulate capillary stability and TIF (Fig.…”