Correlation of Glomerular Size With Donor–Recipient Factors and With Response to Injury

Abstract

Supplemental Digital Content is available in the text.

Changes in Glomerular Volume, Sclerosis, and Ischemia at 5 Years after Kidney Transplantation: Incidence and Correlation with Late Graft Failure

“…A recent study on the basis of biopsies for cause suggested that smaller glomeruli late after transplantation (a mean of 7.7 years after-transplant) were associated with worse graft survival. 9 We confirmed this in our study of purely surveillance (not for cause) biopsies, although with an adjustment for all The cv score could not be graded in nine 5-year biopsies. Banff scores, the association between smaller glomeruli at 5 years and poor graft survival was attenuated.…”

“…In both studies, biopsies with larger glomeruli had lower Banff scores, with the exception of those with cg scores-a rare histologic finding in both studies. 9 To our knowledge, our study is the first to assess the late percentage of ischemic glomeruli and the late percentage of GSG in transplant surveillance biopsies. One novel finding in this study was that compared with implantation biopsy, glomerulosclerosis was similar at the 1-year biopsy, whereas the percentage of ischemic glomeruli was almost five-fold higher.…”

“…A recent study on the basis of biopsies for cause suggested that smaller glomeruli late after transplantation (a mean of 7.7 years after-transplant) were associated with worse graft survival. 9 We confirmed this in our study of purely surveillance (not for cause) biopsies, although with an adjustment for all Banff scores, the association between smaller glomeruli at 5 years and poor graft survival was attenuated. In both studies, biopsies with larger glomeruli had lower Banff scores, with the exception of those with cg scores—a rare histologic finding in both studies.…”

“…8 Larger glomerular area in for-cause biopsies obtained later after transplantation was associated with lower risk of graft failure. 9 Studies are lacking that simultaneously assess changes in mean glomerular volume and the percentages of GSG and ischemic-appearing glomeruli in surveillance biopsies over multiple time points. The goals of this study were to use quantitative morphometry to study these three glomerular features in surveillance kidney transplant biopsies up to 5 years after transplantation in order (1) to describe changes over time and whether they were related to each other, (2) to correlate these changes with clinical variables and determine whether they predict long-term graft failure (beyond 5 years) not due to death, and (3) to determine if changes add predictive power to the existing Banff schema.…”

Glomerular Size in Transplanted Kidneys: Does Size Matter?

“…Measuring glomeruli would seem like a good idea, and multiple studies in transplanted and native kidneys have found relationships with glomerular size with outcomes, although not always in a common direction. 1,2 In current study published in this edition of Transplantation , 3 Grande et al obtained 1027 indication biopsy samples for transplant dysfunction and measured glomerular planar surface area and diameter by image analysis on all glomeruli containing a vascular pole (excluding sclerosed glomeruli) from the 2 cohorts of the Deterioration of Kidney Allograft Function study. BKV infection and recurrent glomerulonephritis were excluded.…”