A brief review of histopathology in kidney transplant recipients immunosuppressed with cyclosporin A.

Kidney transplant biopsies from 54 patients immunosuppressed with Cyclosporin and 38 treated conventional immunosuppression were evaluated by 14 pathologists. As result of the reevaluation of the biopsies during the workshop 6 morphologic reaction patterns in Cyclosporin treated patients were distinguished and possible pathogenetic factors discussed: Classical rejection; Diffuse interstitial fibrosis; Toxic tubulopathy with giant mitochondria, isometric vacuolisation and microcalcification; Intertubular capillary congestion with mononuclear cell accumulation; Arteriolopathy similar to benign/malignant hypertension or hemolytic uremic syndrome; Interstitial fibrosis striped form with tubular atrophy. This preliminary morphologic classification may be helpful in the biopsy interpretation and the selection of therapeutic strategies.