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[Interstitial and glomerular changes in kidney transplants].

M J Mihatsch, M Kyo, F Gudat

    Verhandlungen Der Deutschen Gesellschaft Fur Pathologie
    |January 1, 1989
    PubMed
    Summary
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    This review surveys key kidney transplant lesions, including tubulo-interstitial issues like fibrosis and rejection, and glomerular problems such as transplant glomerulopathy. Understanding these morphologic changes is crucial for transplant outcomes.

    Area of Science:

    • Nephrology
    • Transplant Pathology
    • Immunology

    Context:

    • Kidney transplantation is a vital treatment for end-stage renal disease.
    • Accurate diagnosis of post-transplant complications is essential for patient management.
    • Morphologic analysis of kidney biopsies is the gold standard for diagnosing transplant lesions.

    Purpose:

    • To provide a comprehensive overview of significant tubulo-interstitial and glomerular lesions in kidney allografts.
    • To discuss the differential diagnosis between rejection-associated lesions and glomerulonephritis.
    • To highlight the prognostic significance of various morphologic findings in kidney transplant biopsies.

    Summary:

    • The review details key tubulo-interstitial lesions: subcapsular interstitial fibrosis, acute tubular necrosis, cellular tubulo-interstitial rejection, and cyclosporine-associated nephrotoxicity.

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  • Glomerular lesions covered include intraglomerular coagulation, transplant glomerulitis, and transplant glomerulopathy.
  • Preexisting glomerular diseases and the distinction between rejection and de novo glomerulonephritis are emphasized, supported by data from 500 biopsies.

    • Impact:

    • This review aids clinicians and pathologists in diagnosing and managing kidney transplant recipients.
    • Understanding lesion significance improves prognostic accuracy and patient care strategies.
    • It provides a foundation for further research into the pathogenesis and treatment of transplant kidney diseases.