Purpose: Chronic rejection is the enemy in the battle for long term survival after renal allografts. Interstitial fibrosis is known to be the important finding in renal allografts with chronic rejection. Mast cells secrete a large number
of
fibrogenic factors and have been involved in chronic inflammation and tissue fibrosis. In this study the authors evaluated the relationship between mast cells and fibrosis in renal allografts with chronic rejection.
Methods: The authors evaluated 42 biopsied specimens of renal allografts. Immunohistochemistry using anti-mast cell tryptase (Dako, 1：200) and an LSAB kit (Dako) was applied to detect mast cells. The mean number of mast cells (MNM) per 10
high
power fields was counted.
Results: MNM of implantation biopsies was 0.640±0.537, of acute rejection -1.969±1.216, of chronic rejection -6.0±3.133 (P＜0.01), of acute tubular necrosis -1.360±0.899, and of acute cyclosporine nephrotoxicity -1.000±0.600. MNM
according
to donor source was 3.267±3.479 vs. 2.376±1.900 (living donors vs. cadaveric donors). MNM was significantly correlated with donor sex (male：female ratio of = 2.319±1.739：4.014±4.286, P＜0.01), and cholesterol (hypercholesterolemia vs.
non-hypercholesterolemia, 4.125±5.497 vs. 2.60±1.916, P＜0.01). However, MNM according to blood pressure was not statistically significant (hypertension：non-hypertension ratio of=3.189±3.05：1.200±1.226, P＞0.05).
Conclusion: Our data show that the number of mast cells in renal allograft was significantly associated with chronic rejection, donor sex and hypercholesterolemia.
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