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J Am Soc Nephrol 14:1662-1668, 2003
© 2003 American Society of Nephrology

Computerized Image Analysis of Sirius Red–Stained Renal Allograft Biopsies as a Surrogate Marker to Predict Long-Term Allograft Function

Paul C. Grimm*, Peter Nickerson{dagger}, Jim Gough{ddagger}, Rachel McKenna§, Elzbieta Stern{dagger}, John Jeffery{dagger} and David N. Rush{dagger}

*Department of Pediatrics, University of California at San Diego, California; {dagger}Department of Internal Medicine University of Manitoba, Winnipeg, Manitoba; and Departments of {ddagger}Pathology and §Immunology, University of Calgary, Calgary, Alberta.

Correspondence to Dr. Paul C. Grimm, Division of Pediatric Nephrology, University of California at San Diego, 9500 Gilman Dr. Mail Code 0831, La Jolla, CA 92093-0831. Phone: 619-543-5218; Fax: 619-543-3575;

ABSTRACT. Chronic allograft nephropathy (CAN) is a major problem in posttransplant management. The lack of a reliable and early surrogate marker of CAN has hampered patient care and research. In this study, the Cortical Fractional Interstitial Fibrosis Volume (VIntFib), quantitated with computerized image analysis of Sirius Red–stained protocol biopsies, was examined as a potential surrogate for time to graft failure (TTGF) in 68 renal allograft recipients. At 6 mo posttransplant, VIntFib was highly correlated with TTGF (r = 0.64, P < 0.001). Both the Banff Chronic Sum and the Acute Sum Scores were also correlated with TTGF, but less strongly (r = 0.28, P < 0.02; r = 0.35, P < 0.003, respectively). As VIntFib was not correlated with the Banff Chronic Score, a multivariate model was created that incorporated VIntFib and both Acute and Chronic Banff pathology. This model was highly correlated with TTGF (r = 0.7, P < 0.0001). These findings suggest that VIntFib determined by computerized image analysis of Sirius Red–stained protocol biopsies at 6 mo posttransplant, with or without incorporation of Banff acute and chronic scoring, may provide an early surrogate for time to graft failure in renal allograft recipients. E-mail: pgrimm@ucsd.edu




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