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Int J Hematol. 2008 Mar;87(2):225-230. doi: 10.1007/s12185-008-0026-2. Epub 2008 Feb 9.

Postmortem examination of the kidney in allogeneic hematopoietic stem cell transplantation recipients: possible involvement of graft-versus-host disease.

Author information

1
Department of Hematology, Toranomon Hospital, Tokyo, Japan.
2
Division of Exploratory Research, The Institute of Medical Science, The University of Tokyo, 4-6-1, Shirokanedai, Minato-ku, Tokyo, 1088639, Japan.
3
Division of Exploratory Research, The Institute of Medical Science, The University of Tokyo, 4-6-1, Shirokanedai, Minato-ku, Tokyo, 1088639, Japan. kami-tky@umin.net.
4
Department of Pathology, Toranomon Hospital, Tokyo, Japan.
5
Kidney Center, Toranomon Hospital, Tokyo, Japan.
6
Department of Pathology, Jikei University Kashiwa Hospital, Chiba, Japan.
7
Ministry of Health, Labour and Welfare, Office for Life-Style Related Diseases Control, Tokyo, Japan.
8
Division of Regenerative Medicine, Jichi Medical School, Tochigi, Japan.
9
Department of Nephrology, The Tokyo University Hospital, Tokyo, Japan.
10
Statistics and Cancer Control Division, Research Center for Cancer Prevention and Screening, National Cancer Center, Tokyo, Japan.

Abstract

To investigate the association between graft-versus-host disease (GVHD) and renal injury after allogeneic stem cell transplantation (allo-SCT), we compared autopsy findings of 26 consecutive allo-SCT recipients with two control groups: patients with hematologic malignancies who received cytotoxic chemotherapy alone (Control 1, n = 21) and those with non-hematologic diseases (Control 2, n = 12). We evaluated the following renal pathology; renal tubulitis, allograft glomerulitis, intimal arteritis, allograft nephropathy, and peritubular capillaritis. These changes were found in 11 allo-SCT recipients and 10 patients in Control 1, but none in Control 2. While overall frequency of renal impairments was similar between allo-SCT recipients and Control 1 (3/26 vs. 1/21), allo-SCT recipients were more likely to have renal tubulitis and peritubular capillaritis compared to Control 1 (5/26 vs. 1/21), but less likely to present with glomerulitis (1/26 vs. 6/21). Grade III-IV acute or extensive-type chronic GVHD were seen in all of the three patients with renal tubulitis and four of the five patients with peritubular capillaritis. Allo-SCT recipients with severe GVHD tended to have tubulitis and peritubular capillaritis. These findings have implications of some renal impairment attributable to GVHD.

PMID:
18264743
DOI:
10.1007/s12185-008-0026-2
[Indexed for MEDLINE]

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