title: The potential role of perivascular lymphatic vessels in preservation of kidney allograft function.
abstract: BACKGROUND
  Lymphangiogenesis occurs in diseased native kidneys and kidney allografts, and correlates with histological injury; however, the clinical significance of lymphatic vessels in kidney allografts is unclear.
  
  
  METHODS
  This study retrospectively reviewed 63 kidney transplant patients who underwent protocol biopsies. Lymphatic vessels were identified by immunohistochemical staining for podoplanin, and were classified according to their location as perivascular or interstitial lymphatic vessels. The associations between perivascular lymphatic density and kidney allograft function and pathological findings were analyzed.
  
  
  RESULTS
  There were no significant differences in perivascular lymphatic densities in kidney allograft biopsy specimens obtained at 0 h, 3 months and 12 months. The groups with higher perivascular lymphatic density showed a lower proportion of progression of interstitial fibrosis/tubular atrophy grade from 3 to 12 months (P for trend = 0.039). Perivascular lymphatic density was significantly associated with annual decline of estimated glomerular filtration rate after 12 months (r = -0.31, P = 0.017), even after adjusting for multiple confounders (standardized β = -0.30, P = 0.019).
  
  
  CONCLUSIONS
  High perivascular lymphatic density is associated with favourable kidney allograft function. The perivascular lymphatic network may be involved in inhibition of allograft fibrosis and stabilization of graft function.
authors: Department of Medicine and Clinical Science, Graduate School of Medical Sciences, Kyushu University, Fukuoka, Japan.
authors: Akihiro
authors: A
authors: Tsuchimoto
authors: Department of Medicine and Clinical Science, Graduate School of Medical Sciences, Kyushu University, Fukuoka, Japan.
authors: Toshiaki
authors: T
authors: Nakano
authors: Department of Medicine and Clinical Science, Graduate School of Medical Sciences, Kyushu University, Fukuoka, Japan.
authors: Shoko
authors: S
authors: Hasegawa
authors: Department of Medicine and Clinical Science, Graduate School of Medical Sciences, Kyushu University, Fukuoka, Japan.
authors: Kosuke
authors: K
authors: Masutani
authors: Department of Medicine and Clinical Science, Graduate School of Medical Sciences, Kyushu University, Fukuoka, Japan.
authors: Yuta
authors: Y
authors: Matsukuma
authors: Department of Medicine and Clinical Science, Graduate School of Medical Sciences, Kyushu University, Fukuoka, Japan.
authors: Masahiro
authors: M
authors: Eriguchi
authors: Department of Medicine and Clinical Science, Graduate School of Medical Sciences, Kyushu University, Fukuoka, Japan.
authors: Masaharu
authors: M
authors: Nagata
authors: Department of Surgery and Oncology, Graduate School of Medical Sciences, Kyushu University, Fukuoka, Japan.
authors: Takehiro
authors: T
authors: Nishiki
authors: Department of Surgery and Oncology, Graduate School of Medical Sciences, Kyushu University, Fukuoka, Japan.
authors: Hidehisa
authors: H
authors: Kitada
authors: Department of Surgery and Oncology, Graduate School of Medical Sciences, Kyushu University, Fukuoka, Japan.
authors: Masao
authors: M
authors: Tanaka
authors: Department of Medicine and Clinical Science, Graduate School of Medical Sciences, Kyushu University, Fukuoka, Japan.
authors: Takanari
authors: T
authors: Kitazono
authors: Department of Medicine and Clinical Science, Graduate School of Medical Sciences, Kyushu University, Fukuoka, Japan. tsuruya@intmed2.med.kyushu-u.ac.jp.|Department of Integrated Therapy for Chronic Kidney Disease, Graduate School of Medical Sciences, Kyushu University, 3-1-1 Maidashi, Higashi-ku, Fukuoka, 812-8582, Japan. tsuruya@intmed2.med.kyushu-u.ac.jp.
authors: Kazuhiko
authors: K
authors: Tsuruya
mesh_terms: D000328:Adult; D000368:Aged; D064591:Allografts; D001284:Atrophy; D015415:Biomarkers / Q000032:analysis; D001706:Biopsy; D005260:Female; D005355:Fibrosis; D005919:Glomerular Filtration Rate; D006801:Humans; D007150:Immunohistochemistry; D007668:Kidney / Q000473:pathology / Q000503:physiopathology / Q000601:surgery*; D016030:Kidney Transplantation / Q000009:adverse effects; D042583:Lymphangiogenesis; D042601:Lymphatic Vessels / Q000737:chemistry / Q000473:pathology / Q000503:physiopathology*; D008297:Male; D008562:Membrane Glycoproteins / Q000032:analysis; D008875:Middle Aged; D012189:Retrospective Studies; D016896:Treatment Outcome; D000098853:Podoplanin
chemical_list: D015415:Biomarkers; D008562:Membrane Glycoproteins; C117468:PDPN protein, human; D000098853:Podoplanin
keywords: Angiogenesis; Fibrosis; Kidney allograft; Lymphangiogenesis; Transplantation