Association between C4d staining in renal transplant biopsies, production of donor-specific HLA antibodies, and graft outcome

被引:59
|
作者
Worthington, Judith E.
McEwen, Anna
McWilliam, Lorna J.
Picton, Michael L.
Martin, Susan
机构
[1] Manchester Royal Infirm, Transplantat Lab, Manchester Inst Nephrol & Transplantat, Manchester M13 9WL, Lancs, England
[2] Manchester Royal Infirm, Dept Histopathol, Manchester M13 9WL, Lancs, England
[3] Manchester Royal Infirm, Dept Renal Med, Manchester M13 9WL, Lancs, England
关键词
C4d staining; HLA-specific antibodies; renal transplant outcome;
D O I
10.1097/01.tp.0000251430.11723.b6
中图分类号
R392 [医学免疫学]; Q939.91 [免疫学];
学科分类号
100102 ;
摘要
Background. We carried out a retrospective study of C4d staining in paraffin sections from renal transplant biopsies to determine the association between C4d staining, donor-specific antibodies (DSA), histological features, and graft outcome. Methods. We studied 92 patients who had been biopsied for graft dysfunction. Biopsies were classified using Banff 97 criteria and features suggestive of antibody-mediated rejection were noted. Paraffin sections were stained with a polyclonal antibody using an immunoperoxidase technique. The presence of DSA in concurrent sera was determined by enzyme-linked immunosorbent assay and clinical data were reviewed. Results. Of the 92 cases, 15% showed diffuse and 24% showed focal C4d positivity. The grafts failed in 36% of the diffuse (P < 0.025), 23% of the focal, and 7% of the negative group at between one month and 15 years posttransplantation. Only patients in the group with diffuse C4d positivity had concurrent DSA (five cases, P < 0.001). Of the five DSA-positive patients, three had type 11 acute rejection and two of these transplants subsequently failed. The remaining two had chronic allograft nephropathy with features of alloimmune injury. Only two of the nine DSA-negafive/C4d-positive transplants had failed at the time of writing, in one case due to recurrent disease. Conclusion. We demonstrated a significant association between diffuse C4d staining, production of DSA, and graft failure. Although the concurrent detection of DSA and C4d positivity is uncommon in our patients, these results indicate that outcome in this group is poor and they may benefit from therapies directed at the humoral response.
引用
收藏
页码:398 / 403
页数:6
相关论文
共 50 条
  • [21] TRANSPLANT-INDUCED DONOR-SPECIFIC ANTIBODIES AND GRAFT OUTCOME
    MARTIN, S
    DYER, PA
    MALLICK, NP
    GOKAL, R
    JOHNSON, RWG
    TRANSPLANTATION PROCEEDINGS, 1987, 19 (01) : 899 - 900
  • [22] Association of C1q fixing donor-specific HLA antibodies with late graft failure in pediatric renal transplant recipients
    Fichtner, Alexander
    Suesal, Caner
    Hoecker, Britta
    Rieger, Susi
    Waldherr, Ruediger
    Westhoff, Jens H.
    Sander, Anja
    Opelz, Gerhard
    Toenshoff, Burkhard
    TRANSPLANTATION, 2016, 100 (07) : S138 - S138
  • [23] C4d Staining and Graft Survival in Renal Transplant Recipients.
    Mohiuddin, N.
    Agarwal, S.
    Patel, A.
    Prashar, R.
    AMERICAN JOURNAL OF TRANSPLANTATION, 2018, 18 : 924 - 924
  • [24] HLA donor-specific antibodies (DSA) in renal transplant (RTX) recipients with well functioning graft
    Varnavidou-Nicolaidou, A
    Iniotaki-Theodoraki, AG
    Doxiadis, IIIN
    Georgiou, D
    Patargias, T
    Stavropoulos-Giokas, C
    Kyriakides, G
    GENES AND IMMUNITY, 2005, 6 : S60 - S60
  • [25] Acute Cellular Rejection: Impact of Donor-Specific Antibodies and C4d
    Willicombe, Michelle
    Roufosse, Candice
    Brookes, Paul
    McLean, Adam G.
    Galliford, Jack
    Cairns, Tom
    Cook, Terry H.
    Taube, David
    TRANSPLANTATION, 2014, 97 (04) : 433 - 439
  • [26] C4D FIXATION ON BEADS AS A MARKER FOR C4D STAINING ON RENAL BIOPSIES
    Bajaj, R.
    Brookes, P.
    Warrens, A.
    NEPHROLOGY, 2010, 15 : 72 - 72
  • [27] Clinical significance of C4d positivity of early transplant kidney biopsies from patients with donor-specific antibodies receiving desensitization protocols
    Schroppel, B.
    de Boccardo, G.
    Sehgal, V.
    Dinavahi, R.
    Murphy, B.
    Dikman, S.
    Bromberg, J. S.
    Akalin, E.
    AMERICAN JOURNAL OF TRANSPLANTATION, 2008, 8 : 356 - 356
  • [28] Donor-Specific Anti-HLA Antibodies and Endothelial C4d Deposition-Association With Chronic Liver Allograft Failure
    Iacob, Speranta
    Cicinnati, Vito R.
    Lindemann, Monika
    Heinemann, Falko M.
    Radtke, Arnold
    Kaiser, Gernot M.
    Kabar, Iyad
    Schmidt, Hartmut H. J.
    Baba, Hideo A.
    Beckebaum, Susanne
    TRANSPLANTATION, 2015, 99 (09) : 1869 - 1875
  • [29] Risk factors, histopathological features, and graft outcome of transplant glomerulopathy in the absence of donor-specific HLA antibodies
    Senev, Aleksandar
    Van Loon, Elisabet
    Lerut, Evelyne
    Callemeyn, Jasper
    Coemans, Maarten
    Van Sandt, Vicky
    Kuypers, Dirk
    Emonds, Marie-Paule
    Naesens, Maarten
    KIDNEY INTERNATIONAL, 2021, 100 (02) : 401 - 414
  • [30] C4d STAINING AND HISTOLOGICAL FEATURES OF PROTOCOL LUNG BIOPSIES IN PATIENTS WHO DEVELOP DE NOVO DONOR HLA SPECIFIC ANTIBODIES.
    Askar, Medhat
    Budev, Marie
    Klingman, Lynne
    Zhang, Aiwen
    McCurry, Kenneth
    Farver, Carol
    HUMAN IMMUNOLOGY, 2013, 74 : 87 - 87