Abstract
Cyclosporin A (CsA) and tacrolimus have greatly improved graft survival since their introduction in the 1980 and 1990s, respectively. While the drugs are structurally unrelated, their mechanism of immunosuppression is remarkably similar. The dramatic immunosuppressive and nephrotoxic effects of CsA and tacrolimus are largely explained by their calcineurin inhibition. The pathology of CsA and tacrolimus toxicity is pathologically indistinguishable.
This is a preview of subscription content, log in via an institution to check access.
Access this chapter
Tax calculation will be finalised at checkout
Purchases are for personal use only
References
Mihatsch MJ, Thiel G, Ryffel B (1988) Cyclosporine nephrotoxicity. Adv Nephrol Necker Hosp 17:303–320
Mihatsch MJ, Gudat F, Ryffel B, Thiel G (1994) Cyclosporine nephropathy. In: Tisher CC, Brenner BM (eds) Renal pathology: with clinical and functional correlations, 2nd edn. J.B. Lippincott, Philadelphia, pp 1641–1681
Taube DH, Neild GH, Williams DG, Cameron JS, Hartley B, Ogg CS, Rudge CJ, Welsh KI (1985) Differentiation between allograft rejection and cyclosporin nephrotoxicity in renal transplant recipients. Lancet 2(8448):171–174
Snanoudj R, Royal V, Elie C, Rabant M, Girardin C, Morelon E, Kreis H, Fournet JC, Noel LH, Legendre C (2011) Specificity of histological markers of long-term CNI nephrotoxicity in kidney-transplant recipients under low-dose cyclosporine therapy. Am J Transplant 11:2635–2646
Candinas D, Keusch G, Schlumpf R, Burger HR, Gmur J, Largiader F (1994) Hemolytic-uremic syndrome following kidney transplantation: prognostic factors. Schweiz Med Wochenschr 124:1789–1799
Schwimmer J, Nadasdy TA, Spitalnik PF, Kaplan KL, Zand MS (2003) De novo thrombotic microangiopathy in renal transplant recipients: a comparison of hemolytic uremic syndrome with localized renal thrombotic microangiopathy. Am J Kidney Dis 41:471–479
Neild GH, Taube DH, Hartley RB, Bignardi L, Cameron JS, Williams DG, Ogg CS, Rudge CJ (1986) Morphological differentiation between rejection and cyclosporin nephrotoxicity in renal allografts. J Clin Pathol 39:152–159
Sibley RK, Rynasiewicz J, Ferguson RM, Fryd D, Sutherland DE, Simmons RL, Najarian JS (1983) Morphology of cyclosporine nephrotoxicity and acute rejection in patients immunosuppressed with cyclosporine and prednisone. Surgery 94:225–234
Gardner SD, Field AM, Coleman DV, Hulme B (1971) New human papovavirus (B.K.) isolated from urine after renal transplantation. Lancet 1:1253–1257
Randhawa P, Brennan DC (2006) BK virus infection in transplant recipients: an overview and update. Am J Transplant 6:2000–2005
Colvin RB, Nickeleit V (2006) Renal transplant pathology. In: Jennette JC, Olson JL, Schwartz MM, Silva FG (eds) Heptinstall’s pathology of the kidney, 6th edn. Lippincott-Raven, Philadelphia, pp 1347–1490
Bracamonte E, Leca N, Smith KD, Nicosia RF, Nickeleit V, Kendrick E, Furmanczyk PS, Davis CL, Alpers CE, Kowalewska J (2007) Tubular basement membrane immune deposits in association with BK polyomavirus nephropathy. Am J Transplant 7:1552–1560
Hever A, Nast CC (2008) Polyoma virus nephropathy with simian virus 40 antigen-containing tubular basement membrane immune complex deposition. Hum Pathol 39:73–79
Drachenberg CB, Hirsch HH, Papadimitriou JC, Gosert R, Wali RK, Munivenkatappa R, Nogueira J, Cangro CB, Haririan A, Mendley S, Ramos E (2007) Polyomavirus BK versus JC replication and nephropathy in renal transplant recipients: a prospective evaluation. Transplantation 84:323–330
Singh HK, Andreoni KA, Madden V, True K, Detwiler R, Weck K, Nickeleit V (2009) Presence of urinary Haufen accurately predicts polyomavirus nephropathy. J Am Soc Nephrol 20:416–427
Ramos E, Hirsch HH (2006) Polyomavirus-associated nephropathy: updates on a persisting challenge. Transpl Infect Dis 8:59–61
Drachenberg CB, Hirsch HH, Ramos E, Papadimitriou JC (2005) Polyomavirus disease in renal transplantation: review of pathological findings and diagnostic methods. Hum Pathol 36:1245–1255
Nickeleit V, Klimkait T, Binet IF, Dalquen P, Del Zenero V, Thiel G, Mihatsch MJ, Hirsch HH (2000) Testing for polyomavirus type BK DNA in plasma to identify renal-allograft recipients with viral nephropathy. N Engl J Med 342:1309–1315
Colvin RB, Chang A, Farris AB, Kambham N, Cornell LD, Meehan SM, Liapis H, Bonsib SM, Seshan S, Vasilyev A, Jain S (2011) Diagnostic pathology: kidney diseases. Amirsys Publishing, Salt Lake City
Briganti EM, Russ GR, McNeil JJ, Atkins RC, Chadban SJ (2002) Risk of renal allograft loss from recurrent glomerulonephritis. N Engl J Med 347:103–109
Hariharan S, Adams MB, Brennan DC, Davis CL, First MR, Johnson CP, Ouseph R, Peddi VR, Pelz CJ, Roza AM, Vincenti F, George V (1999) Recurrent and de novo glomerular disease after renal transplantation: a report from Renal Allograft Disease Registry (RADR). Transplantation 68:635–641
Author information
Authors and Affiliations
Rights and permissions
Copyright information
© 2014 Springer-Verlag Berlin Heidelberg
About this chapter
Cite this chapter
Fogo, A.B., Cohen, A.H., Colvin, R.B., Jennette, J.C., Alpers, C.E. (2014). Calcineurin Inhibitor Toxicity, Polyomavirus, and Recurrent Disease. In: Fundamentals of Renal Pathology. Springer, Berlin, Heidelberg. https://doi.org/10.1007/978-3-642-39080-7_21
Download citation
DOI: https://doi.org/10.1007/978-3-642-39080-7_21
Published:
Publisher Name: Springer, Berlin, Heidelberg
Print ISBN: 978-3-642-39079-1
Online ISBN: 978-3-642-39080-7
eBook Packages: MedicineMedicine (R0)