Medical Renal Biopsy / Electron Microscopy Center of Excellence
Clinical WorkThe Medical Renal Biopsy / Electron Microscopy Center of Excellence is based at UPMC Presbyterian Hospital, and is focused on providing diagnostic excellence in medical renal disease for patient care. We work closely with nephrologists, rheumatologists, and other clinical physicians throughout the UPMC Health System and outside of the network of UPMC hospitals, providing comprehensive diagnostic interpretation of medical renal biopsies utilizing light microscopy with histochemical and immunohistochemical stains, immunofluorescence, electron microscopy, and in selected cases flow cytometry, molecular diagnostics, and proteomics. We also provide diagnostic interpretations of non-renal biopsies that require immunofluorescence or electron microscopy, including assessment of poorly differentiated neoplasms, neuromuscular disorders, metabolic storage disorders, and congenital anatomic disorders (e.g. immotile cilia syndrome).
ResearchResearch in Nephropathology at UPMC Presbyterian Hospital COE involves several areas. The division is a participant in the P30 O’Brien Kidney Research Center, which is part of a multicenter group NIH grant to investigate kidney diseases. The Renal Pathology COE is part of the morphology core. We collaborate with other researchers on a variety of projects in the following broad areas:
- clinicopathologic correlation studies in human medical renal disorders
- allograft – related renal disorders
- pathologic assessment in animal models of renal disorders
- role of serum and tissue C4d in lupus nephritis and scleroderma renal crisis
- IgG4 related renal disease, hepatitis C and cryoglobulinemia
- cholesterol atheroembolic renal disease
- renal disorders complicating diabetic nephropathy
Other areas of active research by the Transplant Pathology faculty include the role of C4d in humoral rejection, immune rejection / tolerance, and post-transplant lymphoproliferative disorder. Collaborative projects with researchers investigating animal models of renal disease include pharmacologic manipulations in rat strains with spontaneous diabetes, obesity, and hypertension, mechanism of interstitial fibrosis, renal effects of cigarette smoking in mice, modulation of lymphocyte receptors using adenovirus vectors in a mouse model with spontaneous lupus nephritis, and several knock-out mouse models associated with renal disease.
Pathology residents at UPMC Presbyterian Hospital have a three-week rotation in Medical Renal Biopsy / EM after the PGY-1 year. They receive training in the evaluation of native and allograft renal biopsies including interpretation of light microscopy and ancillary stains, immunofluorescence, and electron microscopy, and correlation of the pathology with the clinical findings. During the second and third weeks of the rotation, residents discuss the provisional pathology findings with the attending nephrologist on the day following the biopsy, and dictate the pathology reports. Three one-hour sessions / week are provided by the Electron Microscopy Laboratory staff, in which residents learn how to use the dissecting microscope to assess adequacy and divide renal biopsies, process biopsies for immunofluorescence and electron microscopy, and use the transmission electron microscope and digital image system. Residents have access to light microscopy and electron microscopy teaching sets, providing the opportunity to see a variety of classic and unusual renal disorders. Residents are encouraged to contribute one electronic case report to the department website. Training in nephropathology is also available to the Transplant Pathology and Nephropathology fellows.