Electron Microscopy Contribution to Diagnosing Transplant Glomerulopathy: A Single-Center Experience

Abstract Background Transplant glomerulopathy (TG) may occur early after transplantation, and electron microscopy may contribute to diagnose it. Methods We analyzed kidney transplant biopsies from September 2009 to September 2012 to identify the presence of histologic changes associated with TG. Res...

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Bibliographic Details
Published in:Transplantation proceedings 2014-11, Vol.46 (9), p.2975-2980
Main Authors: Rigo, D, Barrón, M.B, Martinatto, C, Mukdsi, J, Orías, M, Novoa, P
Format: Article
Language:English
Subjects:
Adult
Biopsy
Female
Graft Rejection - pathology
Graft Survival
Humans
Kidney - pathology
Kidney Transplantation
Male
Microscopy, Electron
Microscopy, Fluorescence
Retrospective Studies
Surgery
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Summary:Abstract Background Transplant glomerulopathy (TG) may occur early after transplantation, and electron microscopy may contribute to diagnose it. Methods We analyzed kidney transplant biopsies from September 2009 to September 2012 to identify the presence of histologic changes associated with TG. Results Forty-eight biopsies from 65 patients, met the study criteria and were evaluated. The average evolution time of transplantation was 13.6 months. Sixty percent of patients received deceased-donor renal transplants, and biopsies were performed per protocol in most cases. Electron microscopy diagnosed the presence of changes associated with TG in 23% of patients. Light microscopy was not useful in the diagnosis of such graft pathology. The average transplantation time was significantly higher in patients with TG compared to patients without TG (20.6 mo vs 11.5 mo; P  = .03). Light microscopy diagnosed mild interstitial fibrosis/tubular atrophy in 27 patients, of which 6 had early changes of TG according to the analysis by electron microscopy. Conclusions Electron microscopy improves accurate diagnosis of TG, in patients both with and without graft dysfunction. It also allows diagnosis of early TG and thereby identification of patients who may have lower graft survival.
ISSN:0041-1345
1873-2623
DOI:10.1016/j.transproceed.2014.07.008