Putative Antibody-Mediated Rejection With C4d Deposition in HLA-Identical, ABO-Compatible Renal Allografts

A. B. Collins, S. L. Chicano, L. D. Cornell, N. Tolkoff-Rubin, N. B. Goes, S. L. Saidman, M. L. Farrell, A. B. Cosimi, R. B. Colvin

Research output: Contribution to journalArticle

18 Citations (Scopus)

Abstract

We sought evidence for non-MHC antibody-mediated rejection in renal allografts by a systematic study of rejected HLA-identical sibling renal allografts. Among 162 recipients of HLA-identical, ABO-compatible sibling donor kidneys transplanted at the Massachusetts General Hospital from 1964 to 2005, we identified 15 grafts that were lost from rejection and two additional grafts with reversible acute rejection, which provided 30 samples for study. All samples were stained for C4d by immunofluorescence in frozen tissue (n = 7) or by immunohistochemistry in paraffin embedded tissues (n = 10). We found that two of 17 grafts had positive C4d staining of peritubular capillaries. Histology revealed acute antibody-mediated rejection in one and acute cellular rejection type 1 in the other. Both grafts were matched at HLA-A, B, and C loci and had a nonreactive mixed lymphocyte response. Genotyping and serological analysis were not available. Compared with a published series, C4d+ irreversible rejection was more common in HLA nonidentical than HLA-identical grafts (75% vs 6.7%, respectively, P < .002). We conclude that antibody-mediated rejection, presumably due to non-MHC antigens other than ABO-blood groups does occur, but infrequently. This may account for some of the HLA antibody negative cases that develop antibody-mediated rejection.

Original languageEnglish (US)
Pages (from-to)3427-3429
Number of pages3
JournalTransplantation Proceedings
Volume38
Issue number10
DOIs
StatePublished - Dec 2006
Externally publishedYes

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Allografts
Transplants
Kidney
Antibodies
HLA-C Antigens
HLA-A Antigens
HLA-B Antigens
Blood Group Antigens
General Hospitals
Paraffin
Fluorescent Antibody Technique
Histology
Immunohistochemistry
Lymphocytes
Staining and Labeling
Antigens

ASJC Scopus subject areas

  • Surgery
  • Transplantation

Cite this

Collins, A. B., Chicano, S. L., Cornell, L. D., Tolkoff-Rubin, N., Goes, N. B., Saidman, S. L., ... Colvin, R. B. (2006). Putative Antibody-Mediated Rejection With C4d Deposition in HLA-Identical, ABO-Compatible Renal Allografts. Transplantation Proceedings, 38(10), 3427-3429. https://doi.org/10.1016/j.transproceed.2006.10.159

Putative Antibody-Mediated Rejection With C4d Deposition in HLA-Identical, ABO-Compatible Renal Allografts. / Collins, A. B.; Chicano, S. L.; Cornell, L. D.; Tolkoff-Rubin, N.; Goes, N. B.; Saidman, S. L.; Farrell, M. L.; Cosimi, A. B.; Colvin, R. B.

In: Transplantation Proceedings, Vol. 38, No. 10, 12.2006, p. 3427-3429.

Research output: Contribution to journalArticle

Collins, AB, Chicano, SL, Cornell, LD, Tolkoff-Rubin, N, Goes, NB, Saidman, SL, Farrell, ML, Cosimi, AB & Colvin, RB 2006, 'Putative Antibody-Mediated Rejection With C4d Deposition in HLA-Identical, ABO-Compatible Renal Allografts', Transplantation Proceedings, vol. 38, no. 10, pp. 3427-3429. https://doi.org/10.1016/j.transproceed.2006.10.159
Collins, A. B. ; Chicano, S. L. ; Cornell, L. D. ; Tolkoff-Rubin, N. ; Goes, N. B. ; Saidman, S. L. ; Farrell, M. L. ; Cosimi, A. B. ; Colvin, R. B. / Putative Antibody-Mediated Rejection With C4d Deposition in HLA-Identical, ABO-Compatible Renal Allografts. In: Transplantation Proceedings. 2006 ; Vol. 38, No. 10. pp. 3427-3429.
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