Luke Ghezzi
Pronouns: He/Him
Research Mentor(s): Evan Farkash
Research Mentor School/College/Department: Department of Pathology / Medicine
Program: UROPF
Session: Session 2 (10:00am – 10:50am)
Authors: Luke Ghezzi, Evan Farkash
Abstract
Introduction: BK Polyomavirus is the most common virus to affect transplanted kidneys. Although the immune system is important for clearing BK infections, inflammation can persist in transplanted kidneys even after the virus is cleared. This inflammation mimics low grade rejection of the graft. We are examining kidney biopsies after clearance of BK viremia to quantify persistent inflammation and identify features to distinguish it from graft rejection. Methods: We obtained 123 biopsies from kidney transplants after clearance of BK viremia (28 scored by me). Biopsies were scored according to the Banff 2017 classification using the i, t, v, g, ptc subscales to quantify inflammation and the ti, ci, ct, and cv subscales to quantify fibrosis or scarring. Biopsies were additionally scored for edema, plasma cells, and C4d and SV40 staining. Results: 46% of transplant biopsies had an i score greater than 0. Additionally, 57% of the biopsies had a ti score of greater than 0 and 60% had a t score greater than 0. Preliminary data shows inflammation has no correlation with graft loss. For grafts with extensive interstitial inflammation 75% (9/12) showed abundant plasma cells at 0-100 days after clearance and 62% (8/13) had abundant plasma cells at 100-200 days (p= 0.67, Fisher exact). Conclusions: Our data suggest that both interstitial and tubular inflammation are common features seen in transplant biopsies after BK viral infections. However, this inflammation was not associated with increased transplant failure. For biopsies with extensive inflammation, plasma cells persisted for at least 6 months post clearance.
