Postmortem examination of the kidney in allogeneic hematopoietic stem cell transplantation recipients: possible involvement of graft-versus-host disease.
To investigate the association between graft-versus-host disease (GVHD) and renal injury after allogeneic stem cell transplantation (allo-SCT), we compared autopsy findings of 26 consecutive allo-SCT recipients with two control groups: patients with hematologic malignancies who received cytotoxic chemotherapy alone (Control 1, n = 21) and those with non-hematologic diseases (Control 2, n = 12). We evaluated the following renal pathology; renal tubulitis, allograft glomerulitis, intimal arteritis, allograft nephropathy, and peritubular capillaritis. These changes were found in 11 allo-SCT recipients and 10 patients in Control 1, but none in Control 2. While overall frequency of renal impairments was similar between allo-SCT recipients and Control 1 (3/26 vs. 1/21), allo-SCT recipients were more likely to have renal tubulitis and peritubular capillaritis compared to Control 1 (5/26 vs. 1/21), but less likely to present with glomerulitis (1/26 vs. 6/21). Grade III-IV acute or extensive-type chronic GVHD were seen in all of the three patients with renal tubulitis and four of the five patients with peritubular capillaritis. Allo-SCT recipients with severe GVHD tended to have tubulitis and peritubular capillaritis. These findings have implications of some renal impairment attributable to GVHD.
Kusumi
Eiji
E
Department of Hematology, Toranomon Hospital, Tokyo, Japan.|Division of Exploratory Research, The Institute of Medical Science, The University of Tokyo, 4-6-1, Shirokanedai, Minato-ku, Tokyo, 1088639, Japan.
Kami
Masahiro
M
Division of Exploratory Research, The Institute of Medical Science, The University of Tokyo, 4-6-1, Shirokanedai, Minato-ku, Tokyo, 1088639, Japan. kami-tky@umin.net.
Hara
Shigeo
S
Department of Pathology, Toranomon Hospital, Tokyo, Japan.
Hoshino
Junichi
J
Kidney Center, Toranomon Hospital, Tokyo, Japan.
Yamaguchi
Yutaka
Y
Department of Pathology, Jikei University Kashiwa Hospital, Chiba, Japan.
Murashige
Naoko
N
Ministry of Health, Labour and Welfare, Office for Life-Style Related Diseases Control, Tokyo, Japan.
Kishi
Yukiko
Y
Division of Regenerative Medicine, Jichi Medical School, Tochigi, Japan.
Shibagaki
Yugo
Y
Department of Nephrology, The Tokyo University Hospital, Tokyo, Japan.
Shibata
Taro
T
Statistics and Cancer Control Division, Research Center for Cancer Prevention and Screening, National Cancer Center, Tokyo, Japan.
Matsumura
Tomoko
T
Department of Hematology, Toranomon Hospital, Tokyo, Japan.|Division of Exploratory Research, The Institute of Medical Science, The University of Tokyo, 4-6-1, Shirokanedai, Minato-ku, Tokyo, 1088639, Japan.
Yuji
Koichiro
K
Department of Hematology, Toranomon Hospital, Tokyo, Japan.
Masuoka
Kazuhiro
K
Department of Hematology, Toranomon Hospital, Tokyo, Japan.
Wake
Atsushi
A
Department of Hematology, Toranomon Hospital, Tokyo, Japan.
Miyakoshi
Shigesaburo
S
Department of Hematology, Toranomon Hospital, Tokyo, Japan.
Taniguchi
Shuichi
S
Department of Hematology, Toranomon Hospital, Tokyo, Japan.
D000293:Adolescent; D000328:Adult; D000368:Aged; D016022:Case-Control Studies; D005260:Female; D006086:Graft vs Host Disease / Q000150:complications*; D018380:Hematopoietic Stem Cell Transplantation / Q000009:adverse effects*; D006801:Humans; D007668:Kidney / Q000473:pathology*; D007674:Kidney Diseases / Q000209:etiology / Q000473:pathology*; D008297:Male; D008875:Middle Aged; D014184:Transplantation, Homologous