Untitled - Roche Trasplantes
Untitled - Roche Trasplantes
Untitled - Roche Trasplantes
You also want an ePaper? Increase the reach of your titles
YUMPU automatically turns print PDFs into web optimized ePapers that Google loves.
BIOPSIA DE PROTOCOLO EN EL TRASPLANTE RENAL<br />
Figure 5. Electron microscopy of a glomerulum showing duplication<br />
of the basement membrane as the morphological<br />
hallmark of chronic transplant glomerulopathy. Typically no<br />
diffuse foot process effacement is seen, electron dense deposits<br />
might be present in the expanded subendothelial space.<br />
• Lamination of peritubular capillary basement membrane, i.e., chronic allograft capillaropathy<br />
(Figure 8).<br />
At 1 year after transplantation around 30% of renal allografts show signs of chronic<br />
humoral rejection, i.e., one or more of the above mentioned morphological features<br />
plus C4d deposition in peritubular capillaries. In parallel to acute humoral rejection<br />
again both, C4d and pathology have to be present to make the diagnosis of chronic<br />
humoral rejection from an allograft biopsy. Frequently additionally to signs of chronic<br />
antibody mediated allograft damage morphological features of acute humoral activity<br />
(capillaritis, glomerulitis) can be observed indicating an acute flare or ongoing antibody<br />
58