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Liapis H, Gaut JP, Klein C, Bagnasco S, Kraus E, Farris AB, Honsova E, Perkowska‐Ptasinska A, David D, Goldberg J, Smith M, Mengel M, Haas M, Seshan S, Pegas KL, Horwedel T, Paliwa Y, Gao X, Landsittel D, Randhawa P. Banff Histopathological Consensus Criteria for Preimplantation Kidney Biopsies. Am J Transplant 2017; 17:140-150. [PMID: 27333454 PMCID: PMC6139430 DOI: 10.1111/ajt.13929] [Citation(s) in RCA: 104] [Impact Index Per Article: 14.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/08/2016] [Revised: 06/14/2016] [Accepted: 06/15/2016] [Indexed: 01/25/2023]
Abstract
The Banff working group on preimplantation biopsy was established to develop consensus criteria (best practice guidelines) for the interpretation of preimplantation kidney biopsies. Digitally scanned slides were used (i) to evaluate interobserver variability of histopathologic findings, comparing frozen sections with formalin-fixed, paraffin-embedded tissue of wedge and needle core biopsies, and (ii) to correlate consensus histopathologic findings with graft outcome in a cohort of biopsies from international medical centers. Intraclass correlations (ICCs) and univariable and multivariable statistical analyses were performed. Good to fair reproducibility was observed in semiquantitative scores for percentage of glomerulosclerosis, arterial intimal fibrosis and interstitial fibrosis on frozen wedge biopsies. Evaluation of frozen wedge and core biopsies was comparable for number of glomeruli, but needle biopsies showed worse ICCs for glomerulosclerosis, interstitial fibrosis and tubular atrophy. A consensus evaluation form is provided to help standardize the reporting of histopathologic lesions in donor biopsies. It should be recognized that histologic parameters may not correlate with graft outcome in studies based on organs deemed to be acceptable after careful clinical assessment. Significant limitations remain in the assessment of implantation biopsies.
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Affiliation(s)
- H. Liapis
- Department of Pathology & ImmunologyWashington University School of MedicineSt LouisMO,NephropathLittle RockAR
| | - J. P. Gaut
- Department of Pathology & ImmunologyWashington University School of MedicineSt LouisMO
| | | | - S. Bagnasco
- Department of Pathology & Internal MedicineJohns Hopkins University HospitalBaltimoreMD
| | - E. Kraus
- Department of Pathology & Internal MedicineJohns Hopkins University HospitalBaltimoreMD
| | | | | | | | - D. David
- University of Sao PauloRenal Transplant ServiceSao PauloBrazil
| | - J. Goldberg
- INCUCAI (Argentinian Nacional Institute for procurement and Implants) and CUCAIBA (Buenos Aires Inst of procurement and implants)Buenos AiresArgentina
| | | | - M. Mengel
- Department of PathologyUniversity of AlbertaAlbertaCanada
| | - M. Haas
- Cedars‐Sinai Medical CenterDepartment of Pathology & Lab MedicineLos AngelesCA
| | - S. Seshan
- Department of PathologyCornell UniversityNew YorkNY
| | - K. L. Pegas
- Santa Casa de Misericordia de Porto Alegre Hospital and Universidade Federal de Ciências da Saúde de Porto AlegreRio Grande do SulBrazil
| | - T. Horwedel
- Department of PharmacyBarnes‐Jewish HospitalSaint LouisMO
| | - Y. Paliwa
- Department of PathologyUniversity of PittsburghThomas E Starzl Transplant InstitutePittsburghPA
| | - X. Gao
- Department of PathologyUniversity of PittsburghThomas E Starzl Transplant InstitutePittsburghPA
| | - D. Landsittel
- Department of PathologyUniversity of PittsburghThomas E Starzl Transplant InstitutePittsburghPA
| | - P. Randhawa
- Department of PathologyUniversity of PittsburghThomas E Starzl Transplant InstitutePittsburghPA
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Soares MF, Caldas MLR, Dos-Santos WLC, Sementilli A, Furtado P, Araújo S, Pegas KL, Petterle RR, Franco MF. IgA nephropathy in Brazil: apropos of 600 cases. Springerplus 2015; 4:547. [PMID: 26435893 PMCID: PMC4582041 DOI: 10.1186/s40064-015-1323-x] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 06/29/2015] [Accepted: 09/08/2015] [Indexed: 11/10/2022]
Abstract
IgA nephropathy (IgAN) is th
e commonest primary glomerular disease worldwide. Studies on its prevalence in Brazil are however scarce. Databases and clinical records from 10 reference centres were retrospectively reviewed. Clinical and laboratory features at the moment of the biopsy were retrieved (age, gender, presence of hematuria, serum creatinine [mg/dL], proteinuria [g/24 h]). Renal biopsy findings were classified according to Haas single grade classification scheme and the Oxford Classification of IgAN. 600 cases of IgAN were identified, of which 568 (94.7 %) were on native kidneys. Male to female ratio was 1.24:1. Patients averaged 32.76 ± 15.12 years old (range 4–89, median 32). Proteinuria and hematuria were observed, respectively in 56.63 and 72.29 % of patients. The association of both these findings occurred in 37.95 % of the cases. Serum creatinine averaged 1.65 ± 0.67 mg/dL (median 1.5 mg/dL) at diagnosis. Segmental sclerosis and mesangial hypercellularity were the main glomerular findings (47.6 and 46.2 %) The commonest combination by Oxford Classification of IgAN, was M0 E0 S0 T0 (22.4 %). Chronic tubulo-interstitial lesions with an extension wider than 25 % of the renal cortex could be identified in 32.2 % of the cases. Tubular atrophy and interstitial fibrosis were more strongly associated with higher 24-h proteinuria and serum creatinine levels. Segmental sclerosis (S1) showed a stronger tendency of association with the presence of tubulo-interstitial lesions (T1 and T2) than other glomerular variables. To the best of our knowledge this is the largest series of IgAN in Brazil. It depicts the main biopsy findings and their possible clinical correlates. Our set of data is comparable to previous reports.
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Affiliation(s)
- Maria Fernanda Soares
- Department of Pathology, Federal University of São Paulo (UNIFESP), São Paulo, Brazil ; Department of Medical Pathology, Federal University of Paraná (UFPR), Curitiba, Brazil ; Brazilian Kidney Club, Brazilian Society of Pathology (SBP), São Paulo, Brazil ; Departamento de Patologia Médica, Rua Padre Camargo, 280, 6. andar, Curitiba, PR 80060-240 Brazil
| | - M L R Caldas
- Department of Pathology, Federal Fluminense University (UFF), Niterói, Brazil ; Brazilian Kidney Club, Brazilian Society of Pathology (SBP), São Paulo, Brazil
| | - W L C Dos-Santos
- Centro de Pesquisas Gonçalo Moniz, Oswaldo Cruz Foundation (CPqGM-FIOCRUZ), Salvador, Brazil ; Brazilian Kidney Club, Brazilian Society of Pathology (SBP), São Paulo, Brazil
| | - A Sementilli
- Santos Metropolitan University (UNIMES) and Ana Costa Hospital, Santos, Brazil ; Brazilian Kidney Club, Brazilian Society of Pathology (SBP), São Paulo, Brazil
| | - P Furtado
- Department of Pathology, Federal University of São Paulo (UNIFESP), São Paulo, Brazil ; Brazilian Kidney Club, Brazilian Society of Pathology (SBP), São Paulo, Brazil
| | - S Araújo
- Clinics Hospital, Federal University of Minas Gerais (UFMG), Belo Horizonte, Brazil ; Federal University of Ouro Preto (UFOP), Ouro Prêto, Brazil
| | - K L Pegas
- Santa Casa de Misericórdia de Porto Alegre, Porto Alegre, Brazil ; Brazilian Kidney Club, Brazilian Society of Pathology (SBP), São Paulo, Brazil
| | - R R Petterle
- Division of Health Sciences, Federal University of Parana (UFPR), Curitiba, Brazil
| | - M F Franco
- Department of Pathology, Federal University of São Paulo (UNIFESP), São Paulo, Brazil ; Brazilian Kidney Club, Brazilian Society of Pathology (SBP), São Paulo, Brazil
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Valar C, Keitel E, Dal Prá RL, Gnatta D, Santos AF, Bianco PD, Sukiennik TCT, Pegas KL, Bittar AE, Oliveira KT, Garcia VD. Parasitic Infection in Renal Transplant Recipients. Transplant Proc 2007; 39:460-2. [PMID: 17362759 DOI: 10.1016/j.transproceed.2007.01.025] [Citation(s) in RCA: 41] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Abstract
The purpose of this study was to evaluate the prevalence of symptomatic parasitic infections in adult renal transplant recipients. We retrospectively analyzed a sample of 657 adult renal transplant recipients performed from January 2001 to December 2005 for immunosuppression protocol, clinical manifestations, parasite diagnosis, treatments, and outcomes. The prevalence of symptomatic parasitosis infections was 2.4% (16/657). None of the infected patients received cyclosporine in their immunosuppression protocol. Most of the infections were caused by Strongyloids stercoralis (n = 11), followed by Giardia lamblia (n = 3), Toxoplasma gondii (n = 1), and Trypanosoma cruzi: (n = 1). Strongyloides stercoralis was the most frequent agent, causing three cases of hyperinfection including one fatal case. With the new immunosuppressive regimes there must be a suspicion of parasitic infection to avoid the diagnostic delay that can be fatal. Strategies, including empiric treatment for S. stercoralis, must be considered.
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Affiliation(s)
- C Valar
- Nephrology Service-Renal and Pancreas Transplant Unit, Complexo Hospitalar Santa Casa de Porto Alegre, Brazil
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