Peritubular capillary basement membrane multilayering in early and advanced transplant glomerulopathy: quantitative parameters and diagnostic aspects.

The ultrastructural quantitative aspects of peritubular capillary basement membrane multilayering (PTCBML) were examined in 57 kidney transplant biopsies with transplant glomerulopathy (TG). The measurements included three cutoffs [permissive: 1 PTC with 5 basement membrane (BM) layers, intermediate...

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Publicado en:Virchows Archiv: European Journal of Pathology Vol. 469; no. 5; pp. 563 - 574
Autores principales: Dobi, Deján, Bodó, Zsolt, Kemény, Éva, Bidiga, László, Hódi, Zoltán, Szenohradszky, Pál, Szederkényi, Edit, Szilvási, Anikó, Iványi, Béla
Formato: Journal Article
Publicado: Springer Nature Nov2016
Acceso en línea:Ver este registro en EBSCOhost
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      dt: Nov2016
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      pub: Springer Nature
      place: New York, New York
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        atl: Peritubular capillary basement membrane multilayering in early and advanced transplant glomerulopathy: quantitative parameters and diagnostic aspects.
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          Dobi, Deján
          Bodó, Zsolt
          Kemény, Éva
          Bidiga, László
          Hódi, Zoltán
          Szenohradszky, Pál
          Szederkényi, Edit
          Szilvási, Anikó
          Iványi, Béla
        affil: Department of Pathology, Faculty of Medicine , University of Szeged , Állomás utca 1 Szeged H-6725 Hungary
      sug:
        subj:
          Kidney Transplantation Methods
          Basement Membrane Pathology
          Graft Rejection
          Kidney Diseases Pathology
          Allografts
          Chronic Disease
          Female
          Complement Metabolism
          Biopsy
          Kidney Diseases Therapy
          Capillaries Pathology
          Male
          Scales
          Female
          Male
      ab: The ultrastructural quantitative aspects of peritubular capillary basement membrane multilayering (PTCBML) were examined in 57 kidney transplant biopsies with transplant glomerulopathy (TG). The measurements included three cutoffs [permissive: 1 PTC with 5 basement membrane (BM) layers, intermediate: 3 PTCs with 5 layers or 1 PTC with 7 layers, strict: 1 PTC with 7 layers and 2 PTCs with 5 layers] and the mean number of BM layers (PTCcirc). Two groups were assigned, namely patients with mild TG (Banff cg1a and cg1b) and those with moderate-to-severe TG (cg2 and cg3). Their respective clinical, serological, and morphological characteristics were then compared. The clinical data revealed that mild TG corresponded to early chronic antibody-mediated rejection (cABMR), while moderate-to-severe TG corresponded to the advanced stage of the disease. The permissive threshold displayed the lowest specificity (73 %) and the highest sensitivity (83 %) for moderate-to-severe TG, and its corresponding PTCcirc value was 3 layers. In contrast, the strict threshold-adopted by the Banff 2013 classification-displayed a specificity and sensitivity of 93 and 52 %, respectively, and the corresponding PTCcirc was 4 layers. In mild TG, 26 % of the cases met the permissive cutoff and 6 % the strict cutoff. Mild TG was associated with a lower PTCcirc (2.6 layers vs 4.5 layers in moderate-to-severe TG; p < 0.0001). Amongst the various criteria, the permissive criterion was associated most frequently with mild TG, and had prognostic relevance. Because of this, we propose its usage as a marker of early cABMR-induced PTCBML if non-alloimmune causes of PTCBML can be ruled out.
      pubtype: Academic Journal
      doctype: Journal Article
      ougenre: Article
    language: English
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