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Significance of C4d Banff Scores in Early Protocol Biopsies of Kidney Transplant Recipients with Preformed Donor-Specific Antibodies (DSA)
| Content Provider | Scilit |
|---|---|
| Author | Loupy, A. Hill, G. S. Suberbielle, C. Charron, D. Anglicheau, D. Zuber, J. Timsit, M. O. Duong, J. P. Bruneval, P. Vernerey, Dewi Empana, J. P. Jouven, X. Nochy, D. Legendre, C. H. |
| Copyright Year | 2010 |
| Description | Journal: American Journal of Transplantation The significance of C4d-Banff scores in protocol biopsies of kidney transplant recipients with preformed donor-specific antibodies (DSA) has not been determined. We reviewed 157 protocol biopsies from 80 DSA+ patients obtained at 3 months and 1 year post-transplant. The C4d Banff scores (1,2,3) were associated with significant increments of microcirculation inflammation (MI) at both 3 months and 1 year post-transplant, worse transplant glomerulopathy and higher class II DSA-MFI (p < 0.01). Minimal-C4d had injury intermediate between negative and focal, while focal and diffuse-C4d had the same degree of microvascular injury. A total of 54% of patients had variation of C4d score between 3 months and 1 year post-transplant. Cumulative (3 month + 1 year) C4d scores correlated with long-term renal function worsening (p = 0.006). However, C4d staining was not a sensitive indicator of parenchymal disease, 55% of C4d-negative biopsies having evidence of concomitant MI. Multivariate analysis demonstrated that the presence of MI and class II DSA at 3 months were associated with a fourfold increased risk of progression to chronic antibody-mediated rejection independently of C4d (p < 0.05). In conclusion, the substantial fluctuation of C4d status in the first year post-transplant reflects a dynamic humoral process. However, C4d may not be a sufficiently sensitive indicator of activity, MI and DSA being more robust predictors of bad outcome. |
| Related Links | https://onlinelibrary.wiley.com/doi/pdf/10.1111/j.1600-6143.2010.03364.x |
| Ending Page | 65 |
| Page Count | 10 |
| Starting Page | 56 |
| e-ISSN | 16006143 |
| DOI | 10.1111/j.1600-6143.2010.03364.x |
| Journal | American Journal of Transplantation |
| Issue Number | 1 |
| Volume Number | 11 |
| Language | English |
| Publisher | Wiley-Blackwell |
| Publisher Date | 2010-12-30 |
| Access Restriction | Open |
| Subject Keyword | Journal: American Journal of Transplantation Chronic Graft Deterioration Donor-specific Antibodies Humoral Allograft Rejection |
| Content Type | Text |
| Resource Type | Article |
