2008 JASN IMPACT FACTOR 7.505	HOME   AUTHOR INFO   EDITORIAL BOARD   SUBSCRIBE   FEEDBACK   ALERTS   HELP
advanced	CURRENT ISSUE	ARCHIVES	JASN Express	ONLINE SUBMISSION

This Article Full Text Full Text (PDF) All Versions of this Article: ASN.2008030279v1 20/1/197    most recent Alert me when this article is cited Alert me if a correction is posted Citation Map Services Email this article to a friend Similar articles in this journal Similar articles in PubMed Alert me to new issues of the journal Download to citation manager Citing Articles Citing Articles via HighWire Citing Articles via Google Scholar Google Scholar Articles by Haas, M. Articles by Montgomery, R. A. Search for Related Content PubMed PubMed Citation Articles by Haas, M. Articles by Montgomery, R. A.

C4d Deposition without Rejection Correlates with Reduced Early Scarring in ABO-Incompatible Renal Allografts

Mark Haas^*, Dorry L. Segev, Lorraine C. Racusen^*, Serena M. Bagnasco^*, Jayme E. Locke, Daniel S. Warren, Christopher E. Simpkins, Diane Lepley, Karen E. King^*, Edward S. Kraus and Robert A. Montgomery

Departments of ^* Pathology, Surgery, and Medicine, Johns Hopkins Medical Institutions, Baltimore, Maryland

Correspondence: Dr. Mark Haas, Department of Pathology, Johns Hopkins University School of Medicine, 600 N. Wolfe Street, Pathology 712, Baltimore, MD 21287. Phone: 410-614-5631; Fax: 410-614-7110; E-mail: mhaas{at}jhmi.edu

Received for publication March 10, 2008. Accepted for publication June 25, 2008.

C4d deposition in peritubular capillaries is a specific marker for the presence of antidonor antibodies in renal transplant recipients and is usually associated with antibody-mediated rejection (AMR) in conventional allografts. In ABO-incompatible grafts, however, peritubular capillary C4d is often present on protocol biopsies lacking histologic features of AMR; the significance of C4d in this setting remains unclear. For addressing this, data from 33 patients who received ABO-incompatible renal allografts (after desensitization) were retrospectively reviewed. Protocol biopsies were performed at 1 and/or 3 and 6 mo after transplantation in each recipient and at 12 mo in 28 recipients. Twenty-one patients (group A) had strong, diffuse peritubular capillary C4d staining without histologic evidence of AMR or cellular rejection on their initial protocol biopsies. The remaining 12 patients (group B) had negative or weak, focal peritubular capillary C4d staining. Three grafts (two in group B) were lost but not as a result of AMR. Excluding these three patients, serum creatinine levels were similar in the two groups at 6 and 12 mo after transplantation and at last follow-up; however, recipients in group A developed significantly fewer overall chronic changes, as scored by the sum of Banff chronic indices, than group B during the first year after transplantation. These results suggest that diffuse peritubular capillary C4d deposition without rejection is associated with a lower risk for scarring in ABO-incompatible renal allografts; the generalizability of these results to conventional allografts remains unknown.

This article has been cited by other articles:

				N. Kieran, X. Wang, J. Perkins, C. Davis, E. Kendrick, R. Bakthavatsalam, N. Dunbar, P. Warner, K. Nelson, K. D. Smith, et al. Combination of Peritubular C4d and Transplant Glomerulopathy Predicts Late Renal Allograft Failure J. Am. Soc. Nephrol., October 1, 2009; 20(10): 2260 - 2268. [Abstract] [Full Text] [PDF]

Copyright © 2009 by the American Society of Nephrology. Online ISSN: 1533-3450 Print ISSN: 1046-6673