Abstract: TH-PO120
A Single Center Observation Study on Findings in Indication Biopsies and Autopsies after Stem Cell Transplantation
Session Information
- Clinical/Diagnostic Renal Pathology and Lab Medicine - I
November 02, 2017 | Location: Hall H, Morial Convention Center
Abstract Time: 10:00 AM - 10:00 AM
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
| Diagnosis | Indication 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 | 0 | 8 (6%) |
| Presence of fungi or bacteriae in the glomeruli/kidney parenchyma | 0 | 6 (4%) |
| Infarction | 0 | 5 (4%) |
| Amyloidosis | 0 | 2 (1%) |
| Fibrillary glomerulonephritis | 0 | 1 (1%) |
| Membranous glomerulonephropathy | 3 (18%) | 1 (1%) |
| Renal vein thrombosis | 0 | 1 (1%) |
| Calcineurin-Inhibitor toxicity | 4 (24%) | 0 |
| IgG4 related interstitial nephritis | 1 (6%) | 0 |