Document Detail


Plasma cell densities and glomerular filtration rates predict renal allograft outcomes following acute rejection.
MedLine Citation:
PMID:  22805456     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
The contribution of T cells and graft-reactive antibodies to acute allograft rejection is widely accepted, but the role of graft-infiltrating B and plasma cells is controversial. We examined 56 consecutive human renal transplant biopsies classified by Banff schema into T-cell-mediated (N = 21), antibody-mediated (N = 18), and mixed (N = 17) acute rejection, using standard immunohistochemistry for CD3, CD20, CD138, and CD45. In a predominantly African-American population (75%), neither Banff classification nor C4d deposition predicted the return to dialysis. Immunohistochemical analysis revealed CD3(+) T cells as the dominant cell type, followed by CD20(+) B cells and CD138(+) plasma cells in all acute rejection types. Using univariate Cox Proportional Hazard analysis, plasma cell density significantly predicted graft failure while B-cell density trended toward significance. Surprisingly T-cell density did not predict graft failure. The estimated glomerular filtration rate (eGFR) at diagnosis of acute rejection also predicted graft failure, while baseline eGFR ≥6 months prior to biopsy did not. Using multivariate analysis, a model including eGFR at biopsy and plasma cell density was most predictive of graft loss. These observations suggest that plasma cells may be a critical mediator and/or an independently sensitive marker of steroid-resistant acute rejection.
Authors:
Anthony Chang; Jocelyn M Moore; Michelle L Cowan; Michelle A Josephson; W James Chon; Roger Sciammas; Zeying Du; Susana R Marino; Shane M Meehan; Michael Millis; Michael Z David; James W Williams; Anita S Chong
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Publication Detail:
Type:  Journal Article; Research Support, N.I.H., Extramural     Date:  2012-07-17
Journal Detail:
Title:  Transplant international : official journal of the European Society for Organ Transplantation     Volume:  25     ISSN:  1432-2277     ISO Abbreviation:  Transpl. Int.     Publication Date:  2012 Oct 
Date Detail:
Created Date:  2012-09-11     Completed Date:  2013-02-11     Revised Date:  2013-10-17    
Medline Journal Info:
Nlm Unique ID:  8908516     Medline TA:  Transpl Int     Country:  England    
Other Details:
Languages:  eng     Pagination:  1050-8     Citation Subset:  IM    
Copyright Information:
© 2012 The Authors. Transplant International © 2012 European Society for Organ Transplantation.
Affiliation:
Departments of Pathology, University of Chicago Medical Center, Chicago, IL 60637, USA. anthony.chang@uchospitals.edu
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MeSH Terms
Descriptor/Qualifier:
Adult
Antigens, CD20 / biosynthesis
Antigens, CD3 / biosynthesis
B-Lymphocytes / immunology
Biopsy / methods
Complement C4b / biosynthesis
Female
Glomerular Filtration Rate
Graft Rejection
Humans
Immunohistochemistry / methods
Kidney Transplantation / methods*
Male
Middle Aged
Peptide Fragments / biosynthesis
Plasma Cells / cytology*
Proportional Hazards Models
Renal Insufficiency / therapy*
Syndecan-1 / biosynthesis
Transplantation, Homologous
Grant Support
ID/Acronym/Agency:
R01 AI083452/AI/NIAID NIH HHS; R01AI083452/AI/NIAID NIH HHS; R03AI069284/AI/NIAID NIH HHS; R56 AI043631/AI/NIAID NIH HHS; UL1 RR024999/RR/NCRR NIH HHS
Chemical
Reg. No./Substance:
0/Antigens, CD20; 0/Antigens, CD3; 0/Peptide Fragments; 0/Syndecan-1; 80295-50-7/Complement C4b; 80295-52-9/complement C4d
Comments/Corrections

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