Histopathologic findings on indication renal allograft biopsies after recovery from acute COVID‐19

Scientific paper - Original scientific paper

• Author: Nikolina Bašić‐Jukić
• Author: Marijana Ćorić
• Author: Stela Bulimbašić
• Author: Živka Dika
• Author: Ivana Jurić
• Author: Vesna Furić‐Čunko
• Author: Lea Katalinić
• Author: Jelena Kos
• Author: Margareta Fištrek
• Author: Željko Kaštelan
• Author: Bojan Jelaković
• Author's institution: University of Zagreb; School of Medicine; (Department of Internal Medicine)
• Author's institution: University of Zagreb; School of Medicine; (Department of Pathology)
• Author's institution: University of Zagreb; School of Medicine; (Department of Urology)
• Scientific / art field, discipline and subdiscipline: BIOMEDICINE AND HEALTHCARE; Clinical Medical Sciences; Internal Medicine
• Scientific / art field, discipline and subdiscipline: BIOMEDICINE AND HEALTHCARE; Clinical Medical Sciences; Pathology
• Scientific / art field, discipline and subdiscipline: BIOMEDICINE AND HEALTHCARE; Clinical Medical Sciences; Urology

Abstract (english)

Current knowledge on histopathological changes occurring after COVID-19 in transplanted kidneys is limited. Herein, we present renal allograft pathology findings in patients recovered from COVID-19. Six patients underwent indication biopsy, and one required allograft nephrectomy after acute COVID-19. Demographic data, clinical characteristics, and laboratory findings were recorded. The histopathological analysis included light microscopy, immunostaining, and electron microscopy. Five patients were hospitalized for acute COVID-19, and all were diagnosed with imaging-confirmed pneumonia, one requiring mechanical ventilation, and two requiring dialysis. Two patients had mild form. Histopathologic examination of renal allograft specimens revealed collapsing, perihilar, tip-lesion and secondary FSGS in one patient each. One patient had borderline acute cellular rejection, and two had chronic antibody-mediated rejection. Histopathologic changes of glomerular tufts were accompanied by acute tubular injury in four patients. None of our patients had signs of viral inclusions in kidney cells. One patient died and one remained dialysis-dependent after the good initial response to treatment. Patients with collapsing and perihilar FSGS had further progression of their chronic allograft nephropathy still without need for dialysis. In conclusion, diverse kidney pathology may be found in SARS-CoV-2-infected renal transplant patients. It seems that viral infection may affect the immune system with triggering of glomerular diseases, while the acute tubular injury is of multifactorial etiology. Direct viral effect is less likely.

• Keywords (english): Acute Kidney Injury; Allografts; Biopsy; COVID-19; Graft Rejection / etiology; Humans; Kidney; Kidney Transplantation / adverse effects; Nephrectomy; SARS-CoV-2
• Language: english
• Publication type: Scientific paper - Original scientific paper
• Publication status: Published
• Peer review: Peer review
• Publication version: Published version
• Journal title: Clinical Transplantation
• Numbering: vol. 35, no. 12, e14486
• p-ISSN: 0902-0063
• e-ISSN: 1399-0012
• DOI: https://doi.org/10.1111/ctr.14486
• URN:NBN: urn:nbn:hr:105:047895
• Publication: 2021-12
• Document URL: https://onlinelibrary.wiley.com/doi/10.1111/ctr.14486
• Type of resource: Text
• Access conditions: Open access
• Created on: 2022-04-28 07:46:24