Clinical utility of histological features of polyomavirus allograft nephropathy.
BACKGROUND
The purpose of this study was to determine if histological features of polyomavirus allograft nephropathy (PVAN) are associated with the clinical presentation and outcomes of PVAN.


METHODS
We examined the histological features of initial and follow-up biopsies of 20 kidney and kidney-pancreas transplant recipients with PVAN during a time prior to routine surveillance. The subjects' demographics, clinical characteristics, and outcomes were compared based upon classification of histological features of PVAN on initial biopsy.


RESULTS
Diabetes mellitus (45%) and a history of tacrolimus-induced nephrotoxicity (35%) appeared to be prevalent in subjects with PVAN. Although histological severity of PVAN did not predict or correlate with the clinical course of PVAN, subjects with pattern C on initial PVAN biopsy presented later posttransplant, had higher serum creatinine level at presentation, and had significant allograft deterioration at follow-up than subjects with either pattern A or B on initial biopsy. Resolution of PVAN was noted in 60% of follow-up biopsies and occurred more frequently in subjects with pattern B on initial biopsy. Most subjects developed chronic allograft nephropathy after PVAN and viral clearance did not abrogate the progression to chronic allograft nephropathy.


CONCLUSIONS
These data indicate that histologic patterns of PVAN may have clinical correlation to disease presentation and prognosis.
Gaber
Lillian W
LW
Department of Pathology, College of Medicine, University of Tennessee Health Science Center, Memphis, 38163, USA. lgaber@utmem.edu
Egidi
M Francesca
MF
Stratta
Robert J
RJ
Lo
Agnes
A
Moore
Linda W
LW
Gaber
A Osama
AO
D000328:Adult; D000998:Antiviral Agents / Q000627:therapeutic use*; D001706:Biopsy; D005260:Female; D005500:Follow-Up Studies; D006084:Graft Rejection / Q000453:epidemiology; D006650:Histocompatibility Testing; D006801:Humans; D007674:Kidney Diseases / Q000821:virology*; D007676:Kidney Failure, Chronic / Q000209:etiology / Q000601:surgery; D016030:Kidney Transplantation / Q000473:pathology*; D008297:Male; D008875:Middle Aged; D009336:Necrosis; D016035:Pancreas Transplantation / Q000473:pathology; D027601:Polyomavirus Infections / Q000188:drug therapy / Q000473:pathology*; D012189:Retrospective Studies; D013997:Time Factors; D014184:Transplantation, Homologous; D016896:Treatment Outcome
D000998:Antiviral Agents