COMPUTER IMAGE ANALYSIS OF GLOMERULAR PLANNER AREA IN ITERATIVE BIOPSIES OF PEDIATRIC RENAL GRAFT.

 

L. Murer, M Della Vella, G Montini, B Andreetta, F Fusaro, C Carasi, G Zacchello.

Department of Pediatrics, University of Padova. Italy

 

Non immune mechanisms are implicated in chronic renal graft damage. In experimental models of uninephrectomy a glomerular compensatory enlargement and hypertrophy could precede sclerosis. We have evaluated using a computer image analysis system the whole glomerular (WG) and tuft (T) planner areas, number of nuclei and glomerular vimentin positivity in iterative biopsies performed in pediatric recipients (R) intraoperatively (T0), at 1sty(T1) and 2ndy(T2) post Tx with stable graft function and without histological rejection (Banff >2) or drug nephrotoxicity. At the present 14 Rs are enrolled: M/F=8/6; D/R mean age 14,6+7,8/14,4+11,7 y; mean weight 38,8+20,3/40,9+19,5 kg; immunosuppression steroids+CsA/FK506+Aza/MMF. No clinical rejection or proteinuria were obseved; at T1 andT2 the mean CrCl was 64+13 and 62+10 ml/m/1.73m2, and the hypertensive Rs were 5/14 and 6/14, respectively. In T0, T1 and T2 b we observed: mean glomeruli number 6,8+1,2, 5,1+1,6 and 5,4+1,4; progressive increase of mean WG (12.855+3.762, 13.634+3.083 and 16.536+4.459 m2) and of mean T (10.475+3.310, 10747+2.670 and 13.512+3.922 m2), but with statistically significant value only for D T1-T2 tuft area (p=0,04). No significant differencies was observed regarding the nuclei number(87+17,77+13,81+11), vimentin distribution (10.5+3.9,14+9.9,11+5.5 %) and intensity (89+22,81+14,80+14 pixel). The D and R weight and age, and the hypertension dont seem to influence the glomerular measures and enlargement. Furthermore the glomerular morphometric parameteres dont seems to be indipendent predictors of ClCr or histological evidence of mesangial hypertrophy or sclerosis at T1 and T2. The number of cases should be increased and the clinical and histological follow-up prolonged to validate these preliminary results.

 

 

 

 

COMPUTER IMAGE ANALYSIS OF GLOMERULAR PLANNER AREA IN ITERATIVE BIOPSIES OF PEDIATRIC RENAL GRAFT.

 

 

 

LUISA MURER,

Department of Pediatrics, University of Padova

Via Giustiniani 3,

35128 Padova

Italy

 

luisam@pediatria.unipd.it