title: Postmortem examination of the kidney in allogeneic hematopoietic stem cell transplantation recipients: possible involvement of graft-versus-host disease.
abstract: 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.
authors.affiliation: 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.
authors.forename: Eiji
authors.initials: E
authors.lastname: Kusumi
authors.affiliation: 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.
authors.forename: Masahiro
authors.initials: M
authors.lastname: Kami
authors.affiliation: Department of Pathology, Toranomon Hospital, Tokyo, Japan.
authors.forename: Shigeo
authors.initials: S
authors.lastname: Hara
authors.affiliation: Kidney Center, Toranomon Hospital, Tokyo, Japan.
authors.forename: Junichi
authors.initials: J
authors.lastname: Hoshino
authors.affiliation: Department of Pathology, Jikei University Kashiwa Hospital, Chiba, Japan.
authors.forename: Yutaka
authors.initials: Y
authors.lastname: Yamaguchi
authors.affiliation: Ministry of Health, Labour and Welfare, Office for Life-Style Related Diseases Control, Tokyo, Japan.
authors.forename: Naoko
authors.initials: N
authors.lastname: Murashige
authors.affiliation: Division of Regenerative Medicine, Jichi Medical School, Tochigi, Japan.
authors.forename: Yukiko
authors.initials: Y
authors.lastname: Kishi
authors.affiliation: Department of Nephrology, The Tokyo University Hospital, Tokyo, Japan.
authors.forename: Yugo
authors.initials: Y
authors.lastname: Shibagaki
authors.affiliation: Statistics and Cancer Control Division, Research Center for Cancer Prevention and Screening, National Cancer Center, Tokyo, Japan.
authors.forename: Taro
authors.initials: T
authors.lastname: Shibata
authors.affiliation: 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.
authors.forename: Tomoko
authors.initials: T
authors.lastname: Matsumura
authors.affiliation: Department of Hematology, Toranomon Hospital, Tokyo, Japan.
authors.forename: Koichiro
authors.initials: K
authors.lastname: Yuji
authors.affiliation: Department of Hematology, Toranomon Hospital, Tokyo, Japan.
authors.forename: Kazuhiro
authors.initials: K
authors.lastname: Masuoka
authors.affiliation: Department of Hematology, Toranomon Hospital, Tokyo, Japan.
authors.forename: Atsushi
authors.initials: A
authors.lastname: Wake
authors.affiliation: Department of Hematology, Toranomon Hospital, Tokyo, Japan.
authors.forename: Shigesaburo
authors.initials: S
authors.lastname: Miyakoshi
authors.affiliation: Department of Hematology, Toranomon Hospital, Tokyo, Japan.
authors.forename: Shuichi
authors.initials: S
authors.lastname: Taniguchi
mesh_terms: 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