Document Detail

Histological markers of humoral rejection in renal transplant patients.
MedLine Citation:
PMID:  17692623     Owner:  NLM     Status:  MEDLINE    
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.
M Valente; L Furian; S Marino; P Rigotti; N De Fazio; M Cardillo; R Cusinato; F B Aiello
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Publication Detail:
Type:  Journal Article    
Journal Detail:
Title:  Transplantation proceedings     Volume:  39     ISSN:  0041-1345     ISO Abbreviation:  Transplant. Proc.     Publication Date:    2007 Jul-Aug
Date Detail:
Created Date:  2007-08-13     Completed Date:  2007-10-12     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  0243532     Medline TA:  Transplant Proc     Country:  United States    
Other Details:
Languages:  eng     Pagination:  1827-9     Citation Subset:  IM    
Institute of Pathological Anatomy, University of Padua Medical School, Padua, Italy.
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MeSH Terms
Antibody Formation*
Antigens, CD / blood
Antigens, CD4 / blood*
Antilymphocyte Serum / therapeutic use
Graft Rejection / immunology*,  pathology
Immunosuppressive Agents / therapeutic use
Kidney Transplantation / immunology*,  pathology
Reg. No./Substance:
0/Antigens, CD; 0/Antigens, CD4; 0/Antilymphocyte Serum; 0/Immunosuppressive Agents

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