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HISTOPATHOLOGICAL LESIONS AND IMMUNOHISTOCHEMICAL MARKERS CHARACTERISTICS IN RENAL ALLOGRAFT BIOPSIES ACCORDING TO THE BANFF 2019 CLASSIFICATION AT MILITARY HOSPITAL 103
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Abstract
Objective: To evaluate the histopathological and immunohistochemical markers characteristics in renal transplanted rejection biopsy specimens. Subjects, and method study: A cross-sectional descriptive study was conducted on 91 renal allograft biopsy specimens collected at Military Hospital 103 from 2021 to 2025. Histopathological features and immunohistochemical markers were assessed according to the Banff 2019 classification. Results: The mean age was 39.1 ± 10.9 years, with a male-to-female ratio of approximately 2.25:1. Chronic active cellular rejection accounted for the highest proportion (51.6%), followed by acute cellular rejection (40.7%). Histopathological lesions were primarily found in the interstitium and tubules. C4d marker expression is 48.4% positive at different levels. IgA, IgM, and IgG markers showed high positivity rates over 33%, SV40 was positive in 27.5% of cases due to Polyomavirus infection. Conclusion: Chronic active cellular rejection was the most common lesion that lead to renal transplant dysfunction, associated with characteristic histopathological changes in the glomeruli, interstitium, and tubules. Immunohistochemical markers IgA, IgM, IgG and C4d were positive at high rates and SV40 was positive in 27.5% of cases, showing the important role of immunohistochemistry in diagnosing post-transplant renal injuries for appropriate treatment options.
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Keywords
Kidney allograft rejection; Histopathology; Immunohistochemistry; Banff classification; Polyomavirus
References
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