Scholarlink

Objective <p>To evaluate kidney biopsy findings to clarify renal disease in patients after hematopoietic stem cell transplantation (HSCT) using unrelated umbilical cord blood transplantation (UCBT).</p> Methods <p>We retrospectively examined 14 patients who underwent UCBT at Toranomon Hospital, Tokyo, Japan, from 2015 to 2023 and subsequently developed kidney injury requiring biopsy.</p> Results <p>At biopsy, median urinary protein was 0.57 g/day (IQR, 0.27–1.67), median serum creatinine was 1.97 mg/dL (IQR, 1.81–2.6), and median eGFR was 25.3 mL/min/1.73 m<sup>2</sup> (IQR, 18.1–34.2). In 13 of 14 patients, mesangiolysis, glomerular basement membrane (GBM) duplication, and subendothelial widening without thrombi were observed—lesions defined as glomerular microangiopathy (GMA). Immunofluorescence and electron microscopy revealed no immune deposits typical of membranous nephropathy. Eleven patients showed distinctive arterial and arteriolar changes termed vascular microangiopathy. Nine exhibited severe interstitial fibrosis and tubular basement membrane duplication involving &gt; 50% of the cortex. Human leukocyte antigen (HLA) incompatibility was found in 13 patients (92.9%) and ABO incompatibility in nine (64.2%). C4d positivity in glomeruli or peritubular capillaries was detected in 12 patients (85.7%).</p> Conclusion: <p>The coexistence of glomerular, vascular, and tubulointerstitial microangiopathic lesions was associated with mild proteinuria and renal dysfunction after UCBT. These findings suggest a chronic endothelial injury process distinct from classical thrombotic microangiopathy.</p>

错误：搜索内容不能为空，请输入英文关键词
错误：关键词超出字数限制，请精简
高级检索

Kidney biopsy analysis of 14 cases of renal disease after unrelated cord blood transplantation

  • 期刊论文

  • 出版模式：

    开放获取

  • 发表日期：

    2026年5月16日

查看全文
  • Masato Mizuta,
  • Naoki Sawa,
  • Tatsuya Suwabe,
  • Yuki Oba,
  • Akinari Sekine,
  • Masayuki Yamanouchi,
  • Hiroki Mizuno,
  • Noriko Inoue,
  • Kiho Tanaka,
  • Eiko Hasegawa,
  • Atsushi Wake,
  • Junichi Hoshino,
  • Kei Kono,
  • Kenichi Ohashi,
  • Yutaka Yamaguchi,
  • Makoto Fukuda,
  • Motoaki Miyazono,
  • Takehiko Wada,
  • Yoshifumi Ubara

摘要

Objective

To evaluate kidney biopsy findings to clarify renal disease in patients after hematopoietic stem cell transplantation (HSCT) using unrelated umbilical cord blood transplantation (UCBT).

Methods

We retrospectively examined 14 patients who underwent UCBT at Toranomon Hospital, Tokyo, Japan, from 2015 to 2023 and subsequently developed kidney injury requiring biopsy.

Results

At biopsy, median urinary protein was 0.57 g/day (IQR, 0.27–1.67), median serum creatinine was 1.97 mg/dL (IQR, 1.81–2.6), and median eGFR was 25.3 mL/min/1.73 m2 (IQR, 18.1–34.2). In 13 of 14 patients, mesangiolysis, glomerular basement membrane (GBM) duplication, and subendothelial widening without thrombi were observed—lesions defined as glomerular microangiopathy (GMA). Immunofluorescence and electron microscopy revealed no immune deposits typical of membranous nephropathy. Eleven patients showed distinctive arterial and arteriolar changes termed vascular microangiopathy. Nine exhibited severe interstitial fibrosis and tubular basement membrane duplication involving > 50% of the cortex. Human leukocyte antigen (HLA) incompatibility was found in 13 patients (92.9%) and ABO incompatibility in nine (64.2%). C4d positivity in glomeruli or peritubular capillaries was detected in 12 patients (85.7%).

Conclusion:

The coexistence of glomerular, vascular, and tubulointerstitial microangiopathic lesions was associated with mild proteinuria and renal dysfunction after UCBT. These findings suggest a chronic endothelial injury process distinct from classical thrombotic microangiopathy.