Peritubular Capillaritis in Renal Allografts: Prevalence, Scoring System, Reproducibility and Clinicopathological Correlates
Article first published online: 5 FEB 2008
2008 The Authors Journal compilation © 2008 The American Society of Transplantation and the American Society of Transplant Surgeons
American Journal of Transplantation
Volume 8, Issue 4, pages 819–825, April 2008
How to Cite
Gibson, I. W., Gwinner, W., Bröcker, V., Sis, B., Riopel, J., Roberts, I.S.D., Scheffner, I., Jhangri, G. S. and Mengel, M. (2008), Peritubular Capillaritis in Renal Allografts: Prevalence, Scoring System, Reproducibility and Clinicopathological Correlates. American Journal of Transplantation, 8: 819–825. doi: 10.1111/j.1600-6143.2007.02137.x
- Issue published online: 5 FEB 2008
- Article first published online: 5 FEB 2008
- Received 01 October 2007, revised 06 December 2007 and accepted for publication 11 December 2007
- Peritubular capillary;
- renal transplantation
While glomerulitis is graded according to the Banff classification, no criteria for scoring peritubular capillaritis (PTC) have been established. We retrospectively applied PTC-scoring criteria to 688 renal allograft (46 preimplantation, 461 protocol, 181 indication) biopsies.
A total of 26.3% of all analyzed biopsies had peritubular capillaritis (implant 0%, protocol 17.6%, indication 45.5%; p < 0.0001). The most common capillaritis pattern was of moderate severity (5–10 luminal cells), focal in extent (10–50% of PTC), with a minority of neutrophils. A total of 24% of C4d− compared with 75% of C4d+ biopsies showed capillaritis (p < 0.0001). More than 80% of biopsies with glomerulitis had peritubular capillaritis. A total of 50.4% of biopsies with borderline or T-cell mediated rejection (TCMR) and 14.1% of biopsies without TCMR or antibody-mediated rejection (ABMR) showed capillaritis (p < 0.0001). The inter-observer reproducibility of the PTC-scoring features was fair to moderate. Diffuse capillaritis detected in early protocol biopsies had significant negative prognostic impact in terms of glomerular filtration rate2 years posttransplantation. Indication biopsies show a significantly higher prevalence of capillaritis than protocol biopsies (45.5% vs. 17.6%; p < 0.0001). Capillaritis is more frequent and pronounced in ABMR, but can be observed in TCMR cases. Thus, scoring of peritubular capillaritis is feasible and can provide prognostic and diagnostic information in renal allograft biopsies.