Renal pathology in hematopoietic cell transplantation recipients

Renal pathology in hematopoietic cell transplant recipients: a contemporary biopsy, nephrectomy, and autopsy series

“…8,11,14,16,18,39,45 We encountered focal segmental glomerulosclerosis in 3 of 14 (21%, patient nos. 6-8) patients with renal biopsy.…”

“…None of these cases were included in our prior study. 16 A group of nine consecutive nephrectomies in 2013 for renal cell carcinoma from patients aged 55 years or younger were reviewed as comparative controls for the surgical specimens.…”

“…16,41 For surgical resection specimens, in addition to H&E stains, PAS, Jones, and trichrome stains were performed; PAS stains were evaluated for control nephrectomies. For autopsy specimens, an additional PAS stain and C4d immunohistochemistry (described below) was performed on one kidney block per patient.…”

“…[7][8][9] Numerous descriptive studies, derived from groups of kidney core biopsy specimens from hematopoietic cell transplant recipients with renal dysfunction, have characterized the most common types of glomerulonephritis in hematopoietic cell transplant patients. 8,[10][11][12][13][14][15][16][17][18] These include membranous nephropathy, minimal change disease, and focal segmental glomerulosclerosis. In addition, acute and chronic thrombotic microangiopathy, or 'transplant-associated thrombotic microangiopathy,' has been shown to occur commonly in hematopoietic cell transplant recipients, 8,14,[17][18][19][20][21][22][23][24][25] with smaller reported numbers of membranoproliferative glomerulonephritis, proliferative glomerulonephritis, ANCA-associated glomerulonephritis, and IgA nephropathy.…”

“…8,18,[26][27][28][29][30][31][32][33][34][35][36][37] In studies also examining nonglomerular pathology, kidney specimens also show concomitant tubulointerstitial and vascular changes in hematopoietic cell transplant patients. 8,14,16,19,38,39 A few single-center studies of autopsy kidney specimen in the hematopoietic cell transplant population have been reported, including one large study focused primarily on thrombotic microangiopathy. 20,21,38,40 We retrospectively reviewed our single-center experience with renal pathology in specimens from three groups of hematopoietic cell transplant recipients.…”