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2018 ; 23
(ä): 55
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Pathological assessment of allograft nephrectomy: An Iranian experience
#MMPMID30057639
Mazdak H
; Ghavami M
; Dolatkhah S
; Daneshpajouhnejad P
; Fesharakizadeh M
; Fesharakizadeh S
; Atapour A
; Mahzouni P
; Hashemi M
; Salajegheh R
; Taheri D
J Res Med Sci
2018[]; 23
(ä): 55
PMID30057639
show ga
BACKGROUND: The aim of this study was to determine the pathologic causes of renal
allograft failure in transplant nephrectomy specimens. MATERIALS AND METHODS: In
this cross-sectional study performed in the referral transplant center of
Isfahan, Iran, medical files of all patients who underwent nephrectomy in
2008-2013 were studied. Age at transplantation, sex, donor's characteristics,
causes of primary renal failure, duration of allograft function, and pathologic
reasons of nephrectomy were extracted. Slides of nephrectomy biopsies were
evaluated. Data were analyzed using SPSS. RESULTS: Medical files of 39
individuals (male: 56.4%; mean age: 35.1 ± 16.0 years) were evaluated. The main
disease of patients was hypertension (17.9%), and most cases (64.1%) were
nephrectomized < 6 months posttransplantation. Renal vein thrombosis (RVT)
(51.3%) and T-cell-mediated rejection (TCMR) (41.0%) were the most prevalent
causes of transplanted nephrectomy. Cause of primary renal failure was correlated
to nephrectomy result (P = 0.04). TCMR was the only pathologic finding in all of
patients nephrectomized >2 years posttransplantation. There were 14 cases in
which biopsy results showed a relationship between primary disease of patients
and pathologic assessment of allograft (P = 0.04). A significant relationship
between transplantation-nephrectomy interval and both the nephrectomy result and
histopathologic result existed (P < 0.0001). A relationship between primary
allograft biopsy appearance and further assessment of nephrectomized specimen (P
< 0.001) existed as well. CONCLUSION: The most pathologic diagnoses of
nephrectomy in a period of less than and more than 6 months posttransplantation
were RVT and TCMR, respectively. Early obtained allograft protocol biopsy is
suggested, which leads to better diagnosis of allograft failure.