Glomerular C3c deposition and intravascular macrophage accumulation in early humoral renal allograft rejection signifies a poor short-term outcome.

Mölne, Johan,1958Gothenburg University,Göteborgs universitet,Institutionen för biomedicin, avdelningen för patologi,Institute of Biomedicine, Department of Pathology (author)

C4d deposition in the walls of peritubular capillaries is considered the key phenomenon in the histopathological diagnosis of humoral, i.e. antibody-mediated, allograft rejection. We have earlier proposed that deposition of C3c in glomerular capillaries and simultaneous intravascular accumulation of macrophages in allografts with immediate or early humoral rejection indicates a potentially serious condition with very poor prognosis. The clinical outcome of 45 cadaveric grafts with this phenomenon among 1960 renal allografts transplanted at our centre during 1984-1999, and the recipients of the contralateral kidneys, was retrospectively evaluated. Graft failure occurred in 44/45 grafts within 3 weeks, with graft loss in 33/45 (77%) within 4 months and 37/45 (82%) within 1 year. From the contralateral kidneys, 5/33 (15%) were lost within 1 year. In a recent series of early biopsies, we recognised that of 13 cases showing C4d positivity in peritubular capillaries but lacking C3c in glomeruli, 10/13 (77%) were still functioning after 4 months. The mean number of CD68(+) macrophages per glomerular profile, i.e. the glomerular macrophage index, shows a significant difference between C4d(+)C3c(-) and C4d(+)C3c(+) cases (p<0.001). Our results indicate the existence of a clinically important subgroup of early humoral rejection with particular morphological features.

MEDICIN OCH HÄLSOVETENSKAP Klinisk medicin Annan klinisk medicin hsv//swe
MEDICAL AND HEALTH SCIENCES Clinical Medicine Other Clinical Medicine hsv//eng
MEDICIN OCH HÄLSOVETENSKAP Medicinska och farmaceutiska grundvetenskaper Cell- och molekylärbiologi hsv//swe
MEDICAL AND HEALTH SCIENCES Basic Medicine Cell and Molecular Biology hsv//eng
Adolescent
Adult
Aged
Antigens
CD
Antigens
Differentiation
Myelomonocytic
Biological Markers
analysis
Biopsy
Cadaver
Capillaries
immunology
Complement C3c
analysis
Female
Graft Rejection
diagnosis
immunology
pathology
Humans
Immunohistochemistry
Kidney
blood supply
immunology
pathology
Kidney Transplantation
immunology
pathology
Kidney Tubules
blood supply
pathology
Leukocyte Count
Macrophages
immunology
Male
Middle Aged
Prognosis
Retrospective Studies
Transplantation
Homologous
Treatment Outcome

Nyberg, Gudrun (author)
Blohmé, IngemarGothenburg University,Göteborgs universitet,Institutionen för kliniska vetenskaper,Institute of Clinical Sciences (author)
Rydberg, Lennart,1944Gothenburg University,Göteborgs universitet,Institutionen för biomedicin, avdelningen för klinisk kemi och transfusionsmedicin,Institute of Biomedicine, Department of Clinical Chemistry and Transfusion Medicine(Swepub:gu)xrydle (author)
Breimer, Michael,1951Gothenburg University,Göteborgs universitet,Institutionen för kliniska vetenskaper,Institute of Clinical Sciences(Swepub:gu)xbremi (author)
Svalander, Christian T.,1934Gothenburg University,Göteborgs universitet,Institutionen för biomedicin, avdelningen för patologi,Institute of Biomedicine, Department of Pathology (author)
Göteborgs universitetInstitutionen för biomedicin, avdelningen för patologi (creator_code:org_t)

In:APMIS : acta pathologica, microbiologica, et immunologica Scandinavica: Wiley114:10, s. 700-110903-4641
In:APMIS: Wiley114:10, s. 700-111600-0463

By the author/editor: Mölne, Johan, 19 ...; Nyberg, Gudrun; Blohmé, Ingemar; Rydberg, Lennart ...; Breimer, Michael ...; Svalander, Chris ...

About the subject

MEDICAL AND HEALTH SCIENCES: MEDICAL AND HEAL ...; and Clinical Medicin ...; and Other Clinical M ...

MEDICAL AND HEALTH SCIENCES: MEDICAL AND HEAL ...; and Basic Medicine; and Cell and Molecul ...

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