Mast Cells in Kidney Transplant Biopsies With Borderline T Cell-mediated Rejection and Their Relation to Chronicity

Hilal Varol*, Guus Van Der Elst, Carla C. Baan, Myrthe Van Baardwijk, Dennis A. Hesselink, Jean Paul Duong Van Huyen, Rafael Kramann, Marion Rabant, Thierry P.P. Van Den Bosch, Marian C. Clahsen-Van Groningen*

*Corresponding author for this work

Research output: Contribution to journalArticleAcademicpeer-review

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Background. Mast cells are potential contributors to chronic changes in kidney transplants (KTx). Here, the role of mast cells (MCs) in KTx is investigated in patients with minimal inflammatory lesions. Methods. Fourty-seven KTx biopsies (2009-2018) with borderline pathological evidence for T cell-mediated rejection according to the Banff'17 Update were retrospectively included and corresponding clinical data was collected. Immunohistochemistry for tryptase was performed on formalin-fixed paraffin-embedded sections. Cortical MCs were counted and corrected for area (MC/mm²). Interstitial fibrosis was assessed by Sirius Red staining and quantified using digital image analysis (QuPath). Results. Increased MC number was correlated to donor age (spearman's r = 0.35, P = 0.022), deceased donor kidneys (mean difference = 0.74, t [32.5] = 2.21, P = 0.035), and delayed graft function (MD = 0.78, t [33.9] = 2.43, P = 0.020). Increased MC number was also correlated to the amount of interstitial fibrosis (r = 0.42, P = 0.003) but did not correlate with transplant function over time (r = -0.14, P = 0.36). Additionally, transplant survival 2 y post-biopsy was not correlated to MC number (mean difference = -0.02, t [15.36] = -0.06, P = 0.96). Conclusions. MC number in suspicious (borderline) for acute T cell-mediated rejection is correlated to interstitial fibrosis and time post-transplantation, suggesting MCs to be a marker for cumulative burden of tissue injury. There was no association between MCs and transplant function over time or transplant survival 2 y post-biopsy. It remains unclear whether MCs are just a bystander or have pro-inflammatory or anti-inflammatory effects in the KTx with minimal lesions.

Original languageEnglish
Article numberE1480
JournalTransplantation Direct
Issue number5
Publication statusPublished - 20 Apr 2023

Bibliographical note

Funding Information:
This article is funded by the Department of Pathology, Erasmus Medical Center, Rotterdam, The Netherlands.

Publisher Copyright:
© 2023 Wolters Kluwer Health. All rights reserved.


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