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Review
. 2023 Aug;115(4):199-204.
doi: 10.32074/1591-951X-858. Epub 2023 Jun 13.

Histology for nephrology, from pre-implantation to post-transplant kidney biopsy. Lesson learned from ReBIrth (Renal BIopsy for Kidney Transplantation Therapy)

Anna Caliò  1 , Antonella Barreca  2 , Stefano Marletta  1   3 , Maria Italia Sara Achenza  4 , Marianna Alessi  5 , Roberta Angelico  6 , Luca Apicella  7 , Davide Argiolas  8 , Nicola Bossini  9 , Rosa Carrano  10 , Concetta Carriero  11 , Giuseppe Castellano  12   13 , Giorgia Comai  14 , Caterina Di Bella  15 , Francesco D'Ignoto  16 , Agnese Gallico  9 , Fiorella Gastaldon  17 , Guido Merlotti  18 , Vera Paloschi  19 , Alessandra Panarese  20 , Angelica Parodi  21 , Francesco Perna  22 , Daniela Picciotto  21 , Anna Regalia  12 , Michele Rossini  23 , Enrico Russo  24 , Maria Paola Salerno  22 , Luca Toti  25 , Patrizia Tulissi  26 , Gisella Vischini  14 , Gianluigi Zaza  27 , Albino Eccher  1
Affiliations
Review

Histology for nephrology, from pre-implantation to post-transplant kidney biopsy. Lesson learned from ReBIrth (Renal BIopsy for Kidney Transplantation Therapy)

Anna Caliò et al. Pathologica. 2023 Aug.

Abstract

A meeting entitled Renal BIopsy for Kidney Transplantation Therapy (ReBIrth) took place on May 31st, 2022 in Bologna, Italy. The meeting drew together nephrologists, surgeons, and pathologists and recognized as experts in the field of kidney transplantation in Italy. In this paper, we present our experience working with kidney transplants in the current era of immunosuppression therapy. The primary aim is to report the histopathological characteristics of failed kidney allografts after a consensus of experts reviewed the cases on a wholeslide imaging digital platform. Regardless of the cases discussed, digital pathology was reliable in identifying all the morphological and immunohistochemical features required to improve the correct use of immunosuppressive therapy to prevent graft failure and optimize patient management.

Keywords: digital pathology; immunosuppression; kidney biopsy; kidney transplantation; whole-slide imaging.

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Conflict of interest statement

The authors have nothing to disclose.

Figures

Figure 1.
Figure 1.
Attendees gathered into different working groups during the meeting.
Figure 2.
Figure 2.
Thrombotic microangiopathy. Low (A) and intermediate (B) magnification of kidney biopsy stained with hematoxylin and eosin showed thrombotic microangiopathy in several glomeruli. Higher magnification highlights the comparison of a glomerulus affected and a normal glomerulus (C). Intraluminal fibrin occlusive thrombi in the glomerulus are easily observed (D).
Figure 3.
Figure 3.
Acute T cell-mediated rejection. Tubulitis and foci of tubular destruction with associated regenerative nuclear irregularities can be seen (A, B: PAS staining). Fibrinoid necrosis of the wall vessels is revealed by using different staining (C: PAS; D: AFOG; E: Trichrome), as well as interstitial hemorrhage (F: Trichrome). C4d immunohistochemistry tested negative (G). The inflammatory infiltrate was made up of small CD3-positive T lymphocytes (H). AFOG: Acid Fuchsin Orange G; PAS: Periodic acid-Schiff.
See this image and copyright information in PMC

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