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Glomerular C3c deposition and intravascular macrophage accumulation in early humoral renal allograft rejection signifies a poor short-term outcome.
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- Mölne, Johan, 1958 (author)
- Gothenburg University,Göteborgs universitet,Institutionen för biomedicin, avdelningen för patologi,Institute of Biomedicine, Department of Pathology
- Nyberg, Gudrun (author)
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- Blohmé, Ingemar (author)
- Gothenburg University,Göteborgs universitet,Institutionen för kliniska vetenskaper,Institute of Clinical Sciences
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- (creator_code:org_t)
- Wiley, 2006
- 2006
- English.
- In: APMIS : acta pathologica, microbiologica, et immunologica Scandinavica. - : Wiley. - 0903-4641. ; 114:10, s. 700-11
- Journal article (peer-reviewed)
Abstract
Subject headings
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- 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.
Subject headings
- 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)
Keyword
- 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
Publication and Content Type
- ref (subject category)
- art (subject category)
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