Author/Editor		Ferluga, Dušan; Jurčić, Vesna; Rott, Tomaž; Vizjak, Alenka; Hvala, Anastazija
Title		Accelerated athero-arteriosclerosis in renal allograft
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. 112-6
Language		eng
Abstract		Chronic rejection is the leading cause of the long-term failure of transplanted organs, including kidney allografts, and a progressive obliteration of their vascular bed, also designated obliterative transplant arteriopathy and accelerated graft arteriosclerosis, appears to be crucial. The aim of our study to evaluate semiquantitatively the histomorphologic changes which characterize obliterative transplant arteriopathy in differen arterial and arteriolar segments of 21 surgically removed kidney allografts with chronic rejection. 13 kidneys removed at autopsies create a control group from patients without appearent kidney disease and arterial hypertension. 13 kidneys obtained at autopsies of hypertensive patients served as an additional control group. Standard methodology for semiquantitative light microscopical evaluation of kidney tissue specimens was applied. Our study confirms that obliterative transplant arteriopathy shares histomorphological similarities with vasculopathy of hypertensive nephroangiosclerosis. However, obliterative transplant arteriopathy, which can include intracellular and extracellular lipid accumulation within a diffusely, concentrically thickened, fibroproliferative sclerosing arterial intimal, differs from naturally occuring atherosclerosis, usually involving large elastic type arteries by typical plazues. Mononuclear cell infiltration of arterial intima, frequently in the form of endothelialitis, foam cell clusters and inner focal elastica lamella disruption, were often present in obliterative transplant arteriopathy but regularly absent in hypertensive vasculopathy according to our study. The rather frequently found and peculiar, insudative-sclerosing involvement of juxtaglomerular arterioles and occasionally medullary vasa recta arterioles, contributes to the progression of chronic transplant nephropathy.(Abstract truncated at 2000 characters)
Descriptors		KIDNEY TRANSPLANTATION GRAFT REJECTION ARTERIOSCLEROSIS ENDARTERITIS KIDNEY RENAL ARTERY ATHEROSCLEROSIS AUTOPSY