Abstract: TH-PO120

A Single Center Observation Study on Findings in Indication Biopsies and Autopsies after Stem Cell Transplantation

Session Information

Category: Glomerular

  • 1004 Clinical/Diagnostic Renal Pathology and Lab Medicine

Authors

  • Girsberger, Michael Yannik, None, Basel, Switzerland
  • Hopfer, Helmut, University Hospital Basel, Basel, Switzerland
  • Dickenmann, Michael, Universita Hospital, Basel, Switzerland
  • Menter, Thomas, University Hospital Basel, Basel, Switzerland
Background

Haematopoietic stem cell transplantation (HSCT) is a now widely used therapy both in the treatment of haematolymphoid malignancies as well as other malignant or autoimmune diseases. Renal impairment is an important problem after HSCT, yet its pathophysiology still needs more investigation, especially regarding the correlation of clinical findings and morphologic changes.

Methods

We retrospectively analysed indication renal biopsies and autopsies after HSCT of the HSCT patient cohort of the University Hospital of Basel, Switzerland. Data of patients’ characteristics were retrospectively collected from the clinical records.

Results

The pathology reports of 17 indication biopsies and 137 autopsies were analysed. In the autopsy cohort, the most common changes were due to acute kidney injury (55/137) most likely as a consequence to the deteriorated state of the patients and thrombotic microangiopathy (14/137). In the indication biopsy cohort the most common changes were therapy related (12/17), with thrombotic microangiopathy (5/17) and Calcineurin-Inhibitor toxicity (4/17) representing the majority within this category.

Conclusion

This study gives a comprehensive overview on potential renal complications in HSCT patients and broadens the spectrum of diseases which have to be expected to occur in this special clinical setting.

Renal Findings
DiagnosisIndication biopsy cohort (n=17)
Autopsy cohort (n=137)
Acute tubular damage/necrosis
2 (12%)
55 (40%)
Chronic vascular and interstitial changes
2 (12%)
20 (15%)
Thrombotic microangiopathy
5 (29%)
14 (10%)
Tumour infiltrates
1 (6%)
9 (7%)
Cholaemic nephrosis
08 (6%)
Presence of fungi or bacteriae in the glomeruli/kidney parenchyma
06 (4%)
Infarction0
5 (4%)
Amyloidosis
02 (1%)
Fibrillary glomerulonephritis
01 (1%)
Membranous glomerulonephropathy
3 (18%)
1 (1%)
Renal vein thrombosis
01 (1%)
Calcineurin-Inhibitor toxicity
4 (24%)
0
IgG4 related interstitial nephritis
1 (6%)
0