Peritubular capillary basement membrane changes in chronic renal allograft rejection: Comparison of light microscopic and ultrastructural observations

B. Iványi, Eva Kemeny, Peter Rago, Norbert Lazar, K. Boda, Zita Morvay, P. Szenohradszky, Edit Szederkenyi

Research output: Contribution to journalArticle

14 Citations (Scopus)

Abstract

Marked peritubular capillary basement membrane (PTCBM) multilayering, the ultrastructural feature of chronic antibody-mediated rejection (ABMR) of kidney allografts, was found to correspond histologically to PTCs with thickened BMs; such PTCs have been suggested as a novel histological marker of chronic rejection. We investigated whether scoring of PTCBM thickening can substitute the ultrastructural search for PTCBM multilayering. The thickening was graded in PAS- and Jones-stained sections in 110 biopsies from recipients with a late dysfunction, all examined ultrastructurally for transplant capillaropathy (≥3 PTCs with ≥5 BM layers). Grade 0 indicated no thickening. Grade 1 and grade 2 were assigned when the PTCBMs were as thick as or thicker than those of the non-atrophic tubules, and duplication/chain-like lamination of the PTCBM was noted in ≤3 or ≥4 high-power fields, respectively. The series was enrolled in subgroups of those with and those without histopathological lesions of chronic rejection. Fifty-six biopsies displayed lesions of chronic ABMR. Transplant capillaropathy was demonstrated in 40 biopsies. Grade 2 thickening furnished a substantial interobserver concordance rate (κ = 0.803) and correlated with the transplant capillaropathy. Jones staining performed somewhat better in scoring than PAS staining. Grade 2 thickening was verified in 35 biopsies involving chronic ABMR, and in one control biopsy (sensitivity 61.4%, specificity 0.98). Grade 1 thickening was not suggestive of chronic ABMR at all. In conclusion, grade 2 thickening can be regarded as the histopathological lesion of chronic ABMR; however, electron microscopy remains the gold standard in the assessment of PTCBM changes.

Original languageEnglish
Pages (from-to)321-330
Number of pages10
JournalVirchows Archiv
Volume459
Issue number3
DOIs
Publication statusPublished - Sep 2011

Fingerprint

Basement Membrane
Allografts
Factor IX
Kidney
Biopsy
Light
Antibodies
Transplants
Staining and Labeling
Electron Microscopy
Sensitivity and Specificity

Keywords

  • Chronic antibody-mediated rejection
  • Electron microscopy
  • Histology
  • Kidney allograft
  • Peritubular capillary

ASJC Scopus subject areas

  • Pathology and Forensic Medicine
  • Cell Biology
  • Molecular Biology

Cite this

Peritubular capillary basement membrane changes in chronic renal allograft rejection : Comparison of light microscopic and ultrastructural observations. / Iványi, B.; Kemeny, Eva; Rago, Peter; Lazar, Norbert; Boda, K.; Morvay, Zita; Szenohradszky, P.; Szederkenyi, Edit.

In: Virchows Archiv, Vol. 459, No. 3, 09.2011, p. 321-330.

Research output: Contribution to journalArticle

@article{2786e5d85dd143f3a206d3d6f27d6c04,
title = "Peritubular capillary basement membrane changes in chronic renal allograft rejection: Comparison of light microscopic and ultrastructural observations",
abstract = "Marked peritubular capillary basement membrane (PTCBM) multilayering, the ultrastructural feature of chronic antibody-mediated rejection (ABMR) of kidney allografts, was found to correspond histologically to PTCs with thickened BMs; such PTCs have been suggested as a novel histological marker of chronic rejection. We investigated whether scoring of PTCBM thickening can substitute the ultrastructural search for PTCBM multilayering. The thickening was graded in PAS- and Jones-stained sections in 110 biopsies from recipients with a late dysfunction, all examined ultrastructurally for transplant capillaropathy (≥3 PTCs with ≥5 BM layers). Grade 0 indicated no thickening. Grade 1 and grade 2 were assigned when the PTCBMs were as thick as or thicker than those of the non-atrophic tubules, and duplication/chain-like lamination of the PTCBM was noted in ≤3 or ≥4 high-power fields, respectively. The series was enrolled in subgroups of those with and those without histopathological lesions of chronic rejection. Fifty-six biopsies displayed lesions of chronic ABMR. Transplant capillaropathy was demonstrated in 40 biopsies. Grade 2 thickening furnished a substantial interobserver concordance rate (κ = 0.803) and correlated with the transplant capillaropathy. Jones staining performed somewhat better in scoring than PAS staining. Grade 2 thickening was verified in 35 biopsies involving chronic ABMR, and in one control biopsy (sensitivity 61.4{\%}, specificity 0.98). Grade 1 thickening was not suggestive of chronic ABMR at all. In conclusion, grade 2 thickening can be regarded as the histopathological lesion of chronic ABMR; however, electron microscopy remains the gold standard in the assessment of PTCBM changes.",
keywords = "Chronic antibody-mediated rejection, Electron microscopy, Histology, Kidney allograft, Peritubular capillary",
author = "B. Iv{\'a}nyi and Eva Kemeny and Peter Rago and Norbert Lazar and K. Boda and Zita Morvay and P. Szenohradszky and Edit Szederkenyi",
year = "2011",
month = "9",
doi = "10.1007/s00428-011-1114-x",
language = "English",
volume = "459",
pages = "321--330",
journal = "Virchows Archiv - A Pathological Anatomy and Histopathology",
issn = "0945-6317",
publisher = "Springer Verlag",
number = "3",

}

TY - JOUR

T1 - Peritubular capillary basement membrane changes in chronic renal allograft rejection

T2 - Comparison of light microscopic and ultrastructural observations

AU - Iványi, B.

AU - Kemeny, Eva

AU - Rago, Peter

AU - Lazar, Norbert

AU - Boda, K.

AU - Morvay, Zita

AU - Szenohradszky, P.

AU - Szederkenyi, Edit

PY - 2011/9

Y1 - 2011/9

N2 - Marked peritubular capillary basement membrane (PTCBM) multilayering, the ultrastructural feature of chronic antibody-mediated rejection (ABMR) of kidney allografts, was found to correspond histologically to PTCs with thickened BMs; such PTCs have been suggested as a novel histological marker of chronic rejection. We investigated whether scoring of PTCBM thickening can substitute the ultrastructural search for PTCBM multilayering. The thickening was graded in PAS- and Jones-stained sections in 110 biopsies from recipients with a late dysfunction, all examined ultrastructurally for transplant capillaropathy (≥3 PTCs with ≥5 BM layers). Grade 0 indicated no thickening. Grade 1 and grade 2 were assigned when the PTCBMs were as thick as or thicker than those of the non-atrophic tubules, and duplication/chain-like lamination of the PTCBM was noted in ≤3 or ≥4 high-power fields, respectively. The series was enrolled in subgroups of those with and those without histopathological lesions of chronic rejection. Fifty-six biopsies displayed lesions of chronic ABMR. Transplant capillaropathy was demonstrated in 40 biopsies. Grade 2 thickening furnished a substantial interobserver concordance rate (κ = 0.803) and correlated with the transplant capillaropathy. Jones staining performed somewhat better in scoring than PAS staining. Grade 2 thickening was verified in 35 biopsies involving chronic ABMR, and in one control biopsy (sensitivity 61.4%, specificity 0.98). Grade 1 thickening was not suggestive of chronic ABMR at all. In conclusion, grade 2 thickening can be regarded as the histopathological lesion of chronic ABMR; however, electron microscopy remains the gold standard in the assessment of PTCBM changes.

AB - Marked peritubular capillary basement membrane (PTCBM) multilayering, the ultrastructural feature of chronic antibody-mediated rejection (ABMR) of kidney allografts, was found to correspond histologically to PTCs with thickened BMs; such PTCs have been suggested as a novel histological marker of chronic rejection. We investigated whether scoring of PTCBM thickening can substitute the ultrastructural search for PTCBM multilayering. The thickening was graded in PAS- and Jones-stained sections in 110 biopsies from recipients with a late dysfunction, all examined ultrastructurally for transplant capillaropathy (≥3 PTCs with ≥5 BM layers). Grade 0 indicated no thickening. Grade 1 and grade 2 were assigned when the PTCBMs were as thick as or thicker than those of the non-atrophic tubules, and duplication/chain-like lamination of the PTCBM was noted in ≤3 or ≥4 high-power fields, respectively. The series was enrolled in subgroups of those with and those without histopathological lesions of chronic rejection. Fifty-six biopsies displayed lesions of chronic ABMR. Transplant capillaropathy was demonstrated in 40 biopsies. Grade 2 thickening furnished a substantial interobserver concordance rate (κ = 0.803) and correlated with the transplant capillaropathy. Jones staining performed somewhat better in scoring than PAS staining. Grade 2 thickening was verified in 35 biopsies involving chronic ABMR, and in one control biopsy (sensitivity 61.4%, specificity 0.98). Grade 1 thickening was not suggestive of chronic ABMR at all. In conclusion, grade 2 thickening can be regarded as the histopathological lesion of chronic ABMR; however, electron microscopy remains the gold standard in the assessment of PTCBM changes.

KW - Chronic antibody-mediated rejection

KW - Electron microscopy

KW - Histology

KW - Kidney allograft

KW - Peritubular capillary

UR - http://www.scopus.com/inward/record.url?scp=80052398560&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=80052398560&partnerID=8YFLogxK

U2 - 10.1007/s00428-011-1114-x

DO - 10.1007/s00428-011-1114-x

M3 - Article

C2 - 21720964

AN - SCOPUS:80052398560

VL - 459

SP - 321

EP - 330

JO - Virchows Archiv - A Pathological Anatomy and Histopathology

JF - Virchows Archiv - A Pathological Anatomy and Histopathology

SN - 0945-6317

IS - 3

ER -