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The potential role of perivascular lymphatic vessels in preservation of kidney allograft function

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Abstract

Background

Lymphangiogenesis occurs in diseased native kidneys and kidney allografts, and correlates with histological injury; however, the clinical significance of lymphatic vessels in kidney allografts is unclear.

Methods

This study retrospectively reviewed 63 kidney transplant patients who underwent protocol biopsies. Lymphatic vessels were identified by immunohistochemical staining for podoplanin, and were classified according to their location as perivascular or interstitial lymphatic vessels. The associations between perivascular lymphatic density and kidney allograft function and pathological findings were analyzed.

Results

There were no significant differences in perivascular lymphatic densities in kidney allograft biopsy specimens obtained at 0 h, 3 months and 12 months. The groups with higher perivascular lymphatic density showed a lower proportion of progression of interstitial fibrosis/tubular atrophy grade from 3 to 12 months (P for trend = 0.039). Perivascular lymphatic density was significantly associated with annual decline of estimated glomerular filtration rate after 12 months (r = −0.31, P = 0.017), even after adjusting for multiple confounders (standardized β = −0.30, P = 0.019).

Conclusions

High perivascular lymphatic density is associated with favourable kidney allograft function. The perivascular lymphatic network may be involved in inhibition of allograft fibrosis and stabilization of graft function.

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Acknowledgments

We thank Ms. Hideko Noguchi for providing advice regarding immunohistochemical staining, and Dr Marguerite Elgin and Dr Karen Bysouth (http://www.edanzediting.co.jp) for providing editing assistance.

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Authors and Affiliations

  1. Department of Medicine and Clinical Science, Graduate School of Medical Sciences, Kyushu University, Fukuoka, Japan

    Akihiro Tsuchimoto, Toshiaki Nakano, Shoko Hasegawa, Kosuke Masutani, Yuta Matsukuma, Masahiro Eriguchi, Masaharu Nagata, Takanari Kitazono & Kazuhiko Tsuruya

  2. Department of Surgery and Oncology, Graduate School of Medical Sciences, Kyushu University, Fukuoka, Japan

    Takehiro Nishiki, Hidehisa Kitada & Masao Tanaka

  3. Department of Integrated Therapy for Chronic Kidney Disease, Graduate School of Medical Sciences, Kyushu University, 3-1-1 Maidashi, Higashi-ku, Fukuoka, 812-8582, Japan

    Kazuhiko Tsuruya

Authors
  1. Akihiro Tsuchimoto
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  2. Toshiaki Nakano
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Correspondence to Kazuhiko Tsuruya.

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Conflict of interest

Honoraria: Takanari Kitazono (Bayer Pharmaceutical Co., Bristol-Myers Squibb Co., Daiichi-Sankyo Co.), Kazuhiko Tsuruya (Chugai Pharmaceutical Co., Kyowa Hakko Kirin Co.). Donations: Takanari Kitazono (Astellas Pharma Inc., Daiichi-Sankyo Co., Eisai Co., Kyowa Hakko Kirin Co., Mitsubishi Tanabe Pharma Co., MSD K.K., Ono Pharmaceutical Co., Otsuka Pharmaceutical Co., Sanofi-Aventis Pharmaceutical Co., Takeda Pharmaceutical Co.), Kazuhiko Tsuruya (Chugai Pharmaceutical Co., Kyowa Hakko Kirin Co., Otsuka Pharmaceutical Co., Takeda Pharmaceutical Co.). Endowed department: Kazuhiko Tsuruya (Baxter).

Ethical approval

All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional research committee at which the studies were conducted (IRB approval number 24-54) and with the declaration of Helsinki and the ethical guidelines for epidemiological studies issued by the Ministry of Health, Labour and Welfare of Japan.

Informed consent

Because data were retrospectively obtained from medical records, informed consent was not obtained in accordance with the above ethical guidelines.

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Tsuchimoto, A., Nakano, T., Hasegawa, S. et al. The potential role of perivascular lymphatic vessels in preservation of kidney allograft function. Clin Exp Nephrol 21, 721–731 (2017). https://doi.org/10.1007/s10157-016-1338-9

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  • DOI: https://doi.org/10.1007/s10157-016-1338-9

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