Histological Markers of Humoral Rejection in Renal Transplant Patients

M. Valente, L. Furian, S. Marino, P. Rigotti, N. De Fazio, M. Cardillo, R. Cusinato, F. B. Aiello

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Abstract

Diagnosis of "suspicious humoral rejection" can be formulated in the presence of peritubular capillary (PTC) C4d deposition and one of the following tissue changes: (1) acute tubular necrosis, (2) glomerulitis or presence of polymophonuclear leukocytes or monocytes in PTC, or (3) arteritis. From January 2004 to October 2006, we performed immunohistochemical staining with anti-C4d antibody on 54 renal biopsies from 39 renal transplant patients. In 25 biopsies we observed diffuse (n = 13) or focal (n = 12) C4d deposition. Based on C4d-positivity, patients were divided into three groups: group 1 included 19 C4d-negative patients; group 2, 10 patients with diffuse C4d-positivity; and group 3, 10 patients with focal C4d-positivity. Panel-reaction antibody-positive tests were associated with diffuse C4d-positivity: 50% of group 2 patients showed a positive test, while no group 1 or 3 patients had a positive test (P <.001). Glomerulitis was observed in six biopsies and associated with diffuse C4d staining. Graft loss occurred in 3/10 group 2 patients (30%); 2/19 group 1 patients (10.5%), and 1/10 group 3 patients (10%). Viral infections were experienced in the year of the biopsy by 50% of group 1 patients 80% of group 2 patients, and 100% of group 3 patients (P <.025), indicating a significantly greater number of infections among patients with C4d-positive biopsies. In eight cases, anti-thymocyte globulin was administered less than 21 days before the biopsy: four had diffuse and four had focal C4d positivity.

Original languageEnglish
Pages (from-to)1827-1829
Number of pages3
JournalTransplantation Proceedings
Volume39
Issue number6
DOIs
Publication statusPublished - Jul 2007

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ASJC Scopus subject areas

  • Surgery
  • Transplantation

Cite this

Valente, M., Furian, L., Marino, S., Rigotti, P., De Fazio, N., Cardillo, M., Cusinato, R., & Aiello, F. B. (2007). Histological Markers of Humoral Rejection in Renal Transplant Patients. Transplantation Proceedings, 39(6), 1827-1829. https://doi.org/10.1016/j.transproceed.2007.05.072