Histopathologyandbiomarkersinpredictionofrenalfunctioninchildren after kidney transplantation

abstract Article history: Received 17 January 2014Received in revised form 24 April 2014Accepted 25 April 2014Available online 5 May 2014 Keywords: BiomarkerChildrenGlomerular filtration rateKidney transplantation Background: Early detection of chronic allograft injuryis a major challenge after kidney transplantation (RTx) inadultsandchildren.Wecorrelatedtheexpressionoffourimmunohistochemicalbiomarkers,P-selectinglycopro-tein ligand-1(PSGL-1),vimentin, α-smoothmuscle actin (α-SMA) and collagen IV, to thekidney graft histologyand function in pediatric RTx patients. Methods: We analyzed thehistopathologyand immunohistochemicalstainings of165 biopsiesfrom 56 patients.Histopathology was scored according to Banff '05 classification and biomarker expression semiquantitatively.Glomerular filtration rate (GFR) was measured annually by 51 Cr-EDTA clearance. Results: Inprotocolbiopsies,theexpressionofallfourbiomarkerscorrelatedwiththeinterstitial fibrosisandtubularatrophy(IF/TA)changes,whichincreasedduringthe first36 monthsafterRTx.Atthetimeof18 monthbiopsy,weobservedthe deteriorationofGFRinpatients withhigh( ≥2)IF/TAscore(50 vs.68 ml/min/1.73m