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Histological and clinical findings in patients with post-transplantation and classical encapsulating peritoneal sclerosis: a European multicenter study.

Latus, Joerg; Habib, Sayed M.; Kitterer, Daniel; Korte, Mario R.; Ulmer, Christoph; Fritz, Peter; Davies, Simon; Lambie, Mark; Alscher, M. Dominik; Betjes, Michiel G.H.; Segerer, Stephan; Braun, Niko

Histological and clinical findings in patients with post-transplantation and classical encapsulating peritoneal sclerosis: a European multicenter study. Thumbnail


Authors

Joerg Latus

Sayed M. Habib

Daniel Kitterer

Mario R. Korte

Christoph Ulmer

Peter Fritz

M. Dominik Alscher

Michiel G.H. Betjes

Stephan Segerer

Niko Braun



Abstract

BACKGROUND: Encapsulating peritoneal sclerosis (EPS) commonly presents after peritoneal dialysis has been stopped, either post-transplantation (PT-EPS) or after switching to hemodialysis (classical EPS, cEPS). The aim of the present study was to investigate whether PT-EPS and cEPS differ in morphology and clinical course. METHODS: In this European multicenter study we included fifty-six EPS patients, retrospectively paired-matched for peritoneal dialysis (PD) duration. Twenty-eight patients developed EPS after renal transplantation, whereas the other twenty-eight patients were classical EPS patients. Demographic data, PD details, and course of disease were documented. Peritoneal biopsies of all patients were investigated using histological criteria. RESULTS: Eighteen patients from the Netherlands and thirty-eight patients from Germany were included. Time on PD was 78(64-95) in the PT-EPS and 72(50-89) months in the cEPS group (p>0.05). There were no significant differences between the morphological findings of cEPS and PT-EPS. Podoplanin positive cells were a prominent feature in both groups, but with a similar distribution of the podoplanin patterns. Time between cessation of PD to the clinical diagnosis of EPS was significantly shorter in the PT-EPS group as compared to cEPS (4(2-9) months versus 23(7-24) months, p<0.001). Peritonitis rate was significantly higher in cEPS. CONCLUSIONS: In peritoneal biopsies PT-EPS and cEPS are not distinguishable by histomorphology and immunohistochemistry, which argues against different entities. The critical phase for PT-EPS is during the first year after transplantation and therefore earlier after PD cessation then in cEPS.

Journal Article Type Article
Acceptance Date Jul 30, 2014
Publication Date Jan 1, 2014
Publicly Available Date Mar 28, 2024
Journal PLoS One
Print ISSN 1932-6203
Publisher Public Library of Science
Peer Reviewed Peer Reviewed
Volume 9
Issue 8
Article Number e106511
DOI https://doi.org/10.1371/journal.pone.0106511
Keywords Biopsy, Inflammation, Fibrosis, Medical dialysis, Peritonitis, Histology, Renal transplantation, Fibrin
Publisher URL http://journals.plos.org/plosone/article?id=10.1371/journal.pone.0106511

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