Faculty Collaboration Database

Bowman capsulitis predicts poor kidney allograft outcome in T cell-mediated rejection. Hum Pathol 2018 Jun;76:47-51

Date

03/05/2018

Pubmed ID

29501487

DOI

10.1016/j.humpath.2018.02.016

Scopus ID

2-s2.0-85046856242 (requires institutional sign-in at Scopus site)   1 Citation

Abstract

Acute T cell-mediated rejection (TCMR) is an important cause of renal allograft loss. The Banff classification for tubulointerstitial (type I) rejection is based on the extent of both interstitial inflammation and tubulitis. Lymphocytes may also be present between parietal epithelial cells and Bowman capsules in this setting, which we have termed "capsulitis." We conducted this study to determine the clinical significance of capsulitis. We identified 42 patients from the pathology archives at The University of Chicago with isolated Banff type I TCMR from 2010 to 2015. Patient demographic data, Banff classification, and graft outcome measurements were compared between capsulitis and noncapsulitis groups using Mann-Whitney U test. Capsulitis was present in 26 (62%) and was more frequently seen in Banff IB than in IA TCMR (88% versus 44%, P = .01). Patients with capsulitis had a higher serum creatinine at biopsy (4.6 versus 2.9 mg/dL, P = .04) and were more likely to progress to dialysis (42% versus 13%, P = .06), with fewer recovering their baseline serum creatinine (12% versus 38%, P = .08). Patients with both Banff IA TCMR and capsulitis have clinical outcomes similar to or possibly worse than Banff IB TCMR compared with those with Banff IA and an absence of capsulitis. Capsulitis is an important pathologic parameter in the evaluation of kidney transplant biopsies with potential diagnostic, prognostic, and therapeutic implications in the setting of TCMR.

Author List

Gallan AJ, Chon WJ, Josephson MA, Cunningham PN, Henriksen KJ, Chang A

Author

Alexander J. Gallan MD Assistant Professor in the Pathology department at Medical College of Wisconsin

MESH terms used to index this publication - Major topics in bold

Adult
Allografts
Biopsy
Bowman Capsule
Chicago
Disease Progression
Female
Graft Rejection
Humans
Immunity, Cellular
Kidney Transplantation
Male
Nephritis
Predictive Value of Tests
Renal Dialysis
Risk Factors
T-Lymphocytes
Treatment Outcome