BACKGROUND: Chronic antibody-mediated rejection is an important cause of late graft failure. Developing an early marker of the disease may allow diagnosis and treatment before irreversible graft damage has occurred. The aim of this study was to assess whether, on electron microscopy examination, peritubular capillary (PTC) basement membrane multilayering precedes and predicts the development of transplant glomerulopathy (TG). METHODS: We used a vintage matched case-control method. Sixteen case-control pairs were created among all renal transplant patients from October 2005. Cases were patients who developed TG, and controls were patients with a late (>36 months) posttransplant (indication or surveillance) biopsy without TG. Electron microscopy was carried out on a biopsy taken earlier in the posttransplantation period for both cases and controls. RESULTS: For every additional PTC of 25 examined with three or more layers in the early biopsy, the risk of having TG in the later biopsy was increased by 1.4-fold (95% confidence interval, 1.1-1.9; P=0.015). For every PTC of 25 with five or more layers, the risk was increased by 1.6-fold (95% confidence interval, 1.0-2.7; P=0.063). Thus, the risk of future TG increased substantially with every additional PTC of 25 showing multilayering in the early biopsy. CONCLUSIONS: Peritubular capillary basement membrane multilayering on electron microscopy is a useful marker of early chronic antibody-mediated damage, and information can be obtained by assessing PTC with three to four layers of basement membrane in addition to those with five or more layers. This finding must be validated in a prospective study.
BACKGROUND: Chronic antibody-mediated rejection is an important cause of late graft failure. Developing an early marker of the disease may allow diagnosis and treatment before irreversible graft damage has occurred. The aim of this study was to assess whether, on electron microscopy examination, peritubular capillary (PTC) basement membrane multilayering precedes and predicts the development of transplant glomerulopathy (TG). METHODS: We used a vintage matched case-control method. Sixteen case-control pairs were created among all renal transplant patients from October 2005. Cases were patients who developed TG, and controls were patients with a late (>36 months) posttransplant (indication or surveillance) biopsy without TG. Electron microscopy was carried out on a biopsy taken earlier in the posttransplantation period for both cases and controls. RESULTS: For every additional PTC of 25 examined with three or more layers in the early biopsy, the risk of having TG in the later biopsy was increased by 1.4-fold (95% confidence interval, 1.1-1.9; P=0.015). For every PTC of 25 with five or more layers, the risk was increased by 1.6-fold (95% confidence interval, 1.0-2.7; P=0.063). Thus, the risk of future TG increased substantially with every additional PTC of 25 showing multilayering in the early biopsy. CONCLUSIONS: Peritubular capillary basement membrane multilayering on electron microscopy is a useful marker of early chronic antibody-mediated damage, and information can be obtained by assessing PTC with three to four layers of basement membrane in addition to those with five or more layers. This finding must be validated in a prospective study.
Authors: Ryan VanDenBerg; Vasilios F Diakonis; Alison Bozung; Gustavo Rosa Gameiro; Oliver Fischer; Ahmed El Dakkak; Jan Paul Ulloa-Padilla; Apostolos Anagnostopoulos; Sander Dubovy; Mohamed Abou Shousha Journal: Cornea Date: 2017-12 Impact factor: 2.651
Authors: Mohamed Abou Shousha; Sonia H Yoo; Mohamed S Sayed; Sean Edelstein; Matthew Council; Ravi S Shah; Joshua Abernathy; Zachary Schmitz; Patrick Stuart; Rocio Bentivegna; Maria P Fernandez; Christopher Smith; Xiaotang Yin; George J Harocopos; Sander R Dubovy; William J Feuer; Jianhua Wang; Victor L Perez Journal: Am J Ophthalmol Date: 2017-03-02 Impact factor: 5.258
Authors: Candice Roufosse; Jan Ulrich Becker; Marion Rabant; Daniel Seron; Maria Irene Bellini; Georg A Böhmig; Klemens Budde; Fritz Diekmann; Denis Glotz; Luuk Hilbrands; Alexandre Loupy; Rainer Oberbauer; Liset Pengel; Stefan Schneeberger; Maarten Naesens Journal: Transpl Int Date: 2022-05-20 Impact factor: 3.842
Authors: Michelle Willicombe; Jill Moss; Linda Moran; Paul Brookes; Eva Santos-Nunez; Adam G McLean; Thomas Cairns; David Taube; Terence H Cook; Candice Roufosse Journal: J Am Soc Nephrol Date: 2015-11-27 Impact factor: 10.121
Authors: Christopher Smith; Daniel Kaitis; Jordan Winegar; Sean Edelstein; Matthew Council; George Kontadakis; Rocio Bentivegna; Mohamed Abou Shousha Journal: Ther Adv Ophthalmol Date: 2018-12-03
Authors: Carlos Jiménez; María Ovidia López; Amaia Ros; Ana Aguilar; David Menendez; Begoña Rivas; María José Santana; Marco Antonio Vaca; Fernando Escuin; Rosario Madero; Rafael Selgas Journal: PLoS One Date: 2016-03-07 Impact factor: 3.240