BACKGROUND: Chronic allograft nephropathy (CAN) has become the predominant limiting factor for long-term transplant survival. A cardinal histomorphologic correlate for CAN is interstitial fibrosis. Currently, no method has been established in routine use that reliably quantifies the extent of interstitial fibrosis in renal grafts. We have used staining with picrosirius red followed by computerized image analysis to study the correlation between graft fibrosis and future development of glomerular filtration rate (GFR) in a group of children with advanced CAN. METHODS: Renal biopsies were performed in 56 children (mean age, 13.7+/-3.6 years) after a mean period of 4.6+/-3.1 years after transplantation because of significant increases in serum creatinine. All biopsy specimens were stained with picrosirius red. The magnitude of fibrotic tissue was calculated by computerized image analysis. Linear regression analysis was performed correlating the intensity of graft fibrosis and the changes in the GFR at the time points of renal biopsy and 2 years later. RESULTS: There was a significant positive correlation (r=0.62, P<0.001) between the picrosirius red-stained cortical fractional interstitial fibrosis volume (V(intFib)) and the decrease of GFR within 2 years postrenal biopsy. When V(intFib) was below 5%, 82% of the patients had an increase in GFR within 2 years. Ninety-three percent of the patients with greater than 10% of fibrosis experienced a worsening renal function after 2 years. When comparing patients with stable GFR with patients having a decrease in GFR, a highly significant difference in V(intFib) was found (P=0.008). CONCLUSIONS: The quantitative measurement of fibrosis by picrosirius red staining appears to be a useful prognostic indicator for estimating long-term graft function in CAN and may provide an easy, fast, and inexpensive tool helpful for treatment decisions in patients developing CAN.
BACKGROUND:Chronic allograft nephropathy (CAN) has become the predominant limiting factor for long-term transplant survival. A cardinal histomorphologic correlate for CAN is interstitial fibrosis. Currently, no method has been established in routine use that reliably quantifies the extent of interstitial fibrosis in renal grafts. We have used staining with picrosirius red followed by computerized image analysis to study the correlation between graft fibrosis and future development of glomerular filtration rate (GFR) in a group of children with advanced CAN. METHODS: Renal biopsies were performed in 56 children (mean age, 13.7+/-3.6 years) after a mean period of 4.6+/-3.1 years after transplantation because of significant increases in serum creatinine. All biopsy specimens were stained with picrosirius red. The magnitude of fibrotic tissue was calculated by computerized image analysis. Linear regression analysis was performed correlating the intensity of graft fibrosis and the changes in the GFR at the time points of renal biopsy and 2 years later. RESULTS: There was a significant positive correlation (r=0.62, P<0.001) between the picrosirius red-stained cortical fractional interstitial fibrosis volume (V(intFib)) and the decrease of GFR within 2 years postrenal biopsy. When V(intFib) was below 5%, 82% of the patients had an increase in GFR within 2 years. Ninety-three percent of the patients with greater than 10% of fibrosis experienced a worsening renal function after 2 years. When comparing patients with stable GFR with patients having a decrease in GFR, a highly significant difference in V(intFib) was found (P=0.008). CONCLUSIONS: The quantitative measurement of fibrosis by picrosirius red staining appears to be a useful prognostic indicator for estimating long-term graft function in CAN and may provide an easy, fast, and inexpensive tool helpful for treatment decisions in patients developing CAN.
Authors: Vincent Vuiblet; Michael Fere; Cyril Gobinet; Philippe Birembaut; Olivier Piot; Philippe Rieu Journal: J Am Soc Nephrol Date: 2015-12-18 Impact factor: 10.121
Authors: Terra N Thimm; Jayne M Squirrell; Yuming Liu; Kevin W Eliceiri; Brenda M Ogle Journal: Tissue Eng Part C Methods Date: 2015-06-17 Impact factor: 3.056
Authors: Andres Moon; Geoffrey H Smith; Jun Kong; Thomas E Rogers; Carla L Ellis; Alton B Brad Farris Journal: Virchows Arch Date: 2017-11-08 Impact factor: 4.064
Authors: Bruce Wang; Brian M Dolinski; Noriko Kikuchi; Diane R Leone; Marion G Peters; Paul H Weinreb; Shelia M Violette; D Montgomery Bissell Journal: Hepatology Date: 2007-11 Impact factor: 17.425
Authors: Alton B Farris; Juan Vizcarra; Mohamed Amgad; Lee A D Cooper; David Gutman; Julien Hogan Journal: Histopathology Date: 2021-03-08 Impact factor: 5.087
Authors: Jan U Becker; David Mayerich; Meghana Padmanabhan; Jonathan Barratt; Angela Ernst; Peter Boor; Pietro A Cicalese; Chandra Mohan; Hien V Nguyen; Badrinath Roysam Journal: Kidney Int Date: 2020-04-01 Impact factor: 10.612