Glomerulitis and endothelial cell enlargement in C4d+ and C4d- acute rejections of renal transplant patients

Francesca B. Aiello, Lucrezia Furian, Mila Della Barbera, Stefano Marino, Michela Seveso, Massimo Cardillo, Elisa S. Pierobon, Emanuele Cozzi, Paolo Rigotti, Marialuisa Valente

Research output: Contribution to journalArticlepeer-review


In acute rejection after renal transplant, glomerulitis is characterized by mononuclear cells in glomerular capillaries and endothelial cell enlargement. In association with C4d deposition in peritubular capillaries, glomerulitis is a feature of acute antibody-mediated rejection. Prognosis in C4d+ rejection is poorer than in C4d- rejection. We measured the glomerular endothelial cell area in C4d+ and C4d- acute rejections by morphometry. In 90 acute rejection biopsies, glomerulitis was present in 36 cases (group G) and absent in 54 (group G0). In biopsies without rejections and in C4d- biopsies of group G0, glomerular endothelial cell area was not significantly different. In C4d- and C4d + biopsies of group G, the area in inflamed glomeruli was greater than that in C4d- biopsies of group G0 (P + biopsies of group G0, it was, unexpectedly, greater than in C4d- biopsies of group G (P + rejections did the presence of glomerulitis increase this association (OR, 9.17; P + and C4d- acute rejections (group G). An increase of this area in C4d+ biopsies without glomerulitis (group G0) suggests complement-mediated damage in the absence of mononuclear cell margination.

Original languageEnglish
Pages (from-to)2157-2166
Number of pages10
JournalHuman Pathology
Issue number12
Publication statusPublished - Dec 2012


  • Humoral rejection
  • Kidney transplant
  • Morphometry

ASJC Scopus subject areas

  • Pathology and Forensic Medicine


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