Author/Editor     Ferluga, Dušan; Jurčić, Vesna; Jeruc, Jera; Vizjak, Alenka
Title     Atheroarteritis in transplantation pathology
Type     članek
Source     In: Pajer Z, Štiblar-Martinčič D, editors. International symposium on cardiovascular diseases. Proceedings of the 29th memorial meeting devoted to prof. dr. Janez Plečnik; 1998 Dec 3-5; Ljubljana. Ljubljana: Medical faculty, Institute of histology and embryology,
Publication year     1998
Volume     str. 285-94
Language     eng
Abstract     Obliterative transplant arteriopathy, also designated atheroarteritis and accelerated graft arterioslerosis, plays a major role in the development of chronic transplant nephropathy and apperas to be crucial for the long-term survival of the transplanted solid organs in general. The main aim of our study was to evaluate semiquantitatively the histopathology of extrarenal and intrarenal arteries and arterioles in 21 kidney allografts surgically removed due to chronic rejection and in 99 needle kidney allograft biopsies of 26 patients with acute rejection, 23 patients with chronic transplant nephropathy and 50 patients with miscellaneous conditions. An age-matched control group of patients without apparent renal disese consisted of 13 kidneys obtained at autopsies, and an additional control group was created with 13 kidneys obtained from autopsied patients with arterial hypertension. Standard methodologies for semiquantitative light microscopical evaluation of kidney tissue specimens were applied. Our study demonstrated that all segments of large extrarenal arteries as well as intrarenal arteries and arterioles are involved inchronic transplant nephropathy by a diffuse fibroproliferative sclerosing intimal hyperplasia, inflammatory insudative and cell infiltrative changes and lipid deposits, although with various intensity. Furthermore, our comparative investigation confirms that obliterative arteriopathy shares histomorphological similarities with vascular renal diseases of various etiopathogenesis, not only with naturally occurring atheroscleosis and other age-related conditions but also with hypertensive vasculopathy, hyperlipidemia-related vascular involvement, cyclosporine-associated hyaline microangiopathy and immune-mediated vasculitides. We believe that the results of our study contribute to the hypothesis of a multifactorial pathogenesis of obliterative graft vasculopathy inwhich immune rejection against the vascular endothelium seems to play a major role.
Descriptors     KIDNEY TRANSPLANTATION
GRAFT OCCLUSION, VASCULAR
ATHEROSCLEROSIS
ARTERITIS
NEPHRECTOMY
AUTOPSY
RENAL ARTERY