The development of 3D X-ray imaging as a tool in the investigation of antibody-mediated kidney transplant rejection

Abstract

The aim of this thesis was to gain a better understanding of the effects of antibody-mediated rejection (AMR), focusing on the glomeruli of kidney transplant recipients. AMR is one of the leading causes of graft loss after an organ transplantation. To collect data, a three-dimensional (3D) imaging technique called holotomography is used to image kidney punch biopsies, taking advantage of the high coherence of X-rays produced by the Deutsches Elektronen Synchrotron (DESY). Data from 79 glomeruli across six patients was collected, focusing on characteristics such as their volume, surface area and sphericity. A correlation was found between a patient's AMR stage and the health status of the investigated glomeruli. In addition, the change in the volume and surface area of globally sclerosed glomeruli compared to healthy and segmentally sclerosed glomeruli was statistically analysed, highlighting the correlation between volume/surface area and the health status of a glomerulus. The plausibility of the results could be confirmed by other studies. However, it must be considered that only a very small random sample was analysed. In order to obtain reliable results, the investigations undertaken here would have to be repeated on a larger scale. It would be important to consider other factors influencing the size of the glomeruli, such as the demographics of a patient. This work underscores the potential of 3D imaging to enhance understanding of AMR's impact and improve diagnostic strategies.