Allograft Biopsies: Studying Them for All They're Worth

[摘要] Advances in short-term renal allograft survival, as a result in large part of the use of calcineurin inhibitors (CNIs), have not translated into increased organ longevity.1 For decades, researchers have tried to uncover the pathogenesis of chronic graft failure using histopathologic examination of human biopsies. Despite these efforts, biopsy evaluation in the setting of chronic graft failure is often a frustrating experience for nephrologist and nephropathologist alike. There is consensus that the most frequent biopsy findings in long-term graft failure (censored for death) result from cumulative injuries to the graft, which produce a pathologic pattern of scarring involving all renal compartments.2 Controversy over the term used to describe these findings (chronic allograft nephropathy versus interstitial fibrosis and tubular atrophy (IF/TA) is less important than the recognition that the dominant changes seen by routine microscopy represent a nonspecific common injury pathway, not a diagnosis, and that in most of those biopsies we lack the ability to determine the underlying cause.3

[学科分类] 泌尿医学

[关键词] Bone marrow necrosis;Sickle cell disease;Hyperhemolysis syndrome