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

doi:10.1016/j.transproceed.2006.10.159

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

Laboratory Medicine and Pathology

Research output: Contribution to journal › Article › peer-review

19 Scopus citations

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 language	English (US)
Pages (from-to)	3427-3429
Number of pages	3
Journal	Transplantation proceedings
Volume	38
Issue number	10
DOIs	https://doi.org/10.1016/j.transproceed.2006.10.159
State	Published - Dec 2006

ASJC Scopus subject areas

Surgery
Transplantation

Access to Document

10.1016/j.transproceed.2006.10.159

Cite this

@article{ce2a96bac77540bf9847869e888ee0ff,

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

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.",

author = "Collins, {A. B.} and Chicano, {S. L.} and Cornell, {L. D.} and N. Tolkoff-Rubin and Goes, {N. B.} and Saidman, {S. L.} and Farrell, {M. L.} and Cosimi, {A. B.} and Colvin, {R. B.}",

year = "2006",

month = dec,

doi = "10.1016/j.transproceed.2006.10.159",

language = "English (US)",

volume = "38",

pages = "3427--3429",

journal = "Transplantation proceedings",

issn = "0041-1345",

publisher = "Elsevier USA",

number = "10",

}

TY - JOUR

T1 - Putative Antibody-Mediated Rejection With C4d Deposition in HLA-Identical, ABO-Compatible Renal Allografts

AU - Collins, A. B.

AU - Chicano, S. L.

AU - Cornell, L. D.

AU - Tolkoff-Rubin, N.

AU - Goes, N. B.

AU - Saidman, S. L.

AU - Farrell, M. L.

AU - Cosimi, A. B.

AU - Colvin, R. B.

PY - 2006/12

Y1 - 2006/12

N2 - 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.

AB - 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.

UR - http://www.scopus.com/inward/record.url?scp=33845393135&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=33845393135&partnerID=8YFLogxK

U2 - 10.1016/j.transproceed.2006.10.159

DO - 10.1016/j.transproceed.2006.10.159

M3 - Article

C2 - 17175293

AN - SCOPUS:33845393135

SN - 0041-1345

VL - 38

SP - 3427

EP - 3429

JO - Transplantation proceedings

JF - Transplantation proceedings

IS - 10

ER -

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

Abstract

ASJC Scopus subject areas

Access to Document

Other files and links

Fingerprint

Cite this