Author/Editor		Vodovnik, Aleksandar; Jurčić, Vesna; Ferluga, Dušan
Title		Non-rejection thrombosis in renal transplant recipients. A light microscopic study of eight cases
Type		članek
Source		In: Bren AF, Ferluga D, Olsen S, et al, editors. Proceedings of the International conference on transplantation with emphasis on kidney; 1998 Oct 8-9; Ljubljana, Slovenia. Ljubljana: Medical faculty, Institute of pathology,
Publication year		1998
Volume		str. 53-5
Language		eng
Abstract		Thrombosis of the renal allograft vessels is among the important complications of kidney transplantation. However, the clinical and histological distinction between rejection and non-rejection thrombosis has been poorly investigated. In our study, 8 explanted renal allografts were investigated. Allografts were removed surgically due to clinically non-rejection thrombosis of large vessels 2 to 31 days after transplantation (8 days on average). Histologically, no signs of acute rejection were found. Reactive vascular changes that should not be confused with rejection vasculitis were seen in 6 allografts, but not in 2 allografts in the early stage of thrombosis. In contrast to mononuclear cell rejection vasculitis, cells infiltrating the vessel walls in nonrejection thrombosis were predominantly neutrophils and macrophages. Proliferative changes, found in 2 allografts, removed more than one week after transplantation, were associated with the organisation of the thrombi. They were characterized by the proliferation of a significant quantity of endothelial cells and, to a lesser extent, of myofibroblasts and connective tissue, while in chronic vascular rejection proliferation of myofibroblasts and sclerosis predominates. Furthermore, vascular changes in non-rejection thrombosis were focal and segmental, limited to common finding of simultaneous multiple thrombi of different age in both extrarenal arteries and veins (5/8 allografts), and intrarenal and extrarenal vessels (4/8 allografts), may be a consequence of local circulatory disturbances and/or release of procoagulant substances following the initial large etrarenal vessel thrombotic obstruction.
Descriptors		KIDNEY TRANSPLANTATION THROMBOSIS TRANSPLANTATION, HOMOLOGOUS KIDNEY BIOPSY