Transplantation Proceedings
Volume 41, Issue 9 , Pages 3697-3700 , November 2009

The Prevalence of C4d-Positive Renal Allografts in 134 Consecutive Biopsies in Thai Patients

  • B. Cheunsuchon

      Affiliations

    • Department of Pathology, Faculty of Medicine, Siriraj Hospital, Mahidol University, Bangkok, Thailand
    • Corresponding Author InformationAddress reprint requests to Dr Boonyarit Cheunsuchon, MD, Siriraj Hospital, Mahidol University, 2 Bangkoknoi, Bangkok 10700, Thailand
    • ,
  • A. Vongwiwatana

      Affiliations

    • Renal Unit, Department of Medicine, Faculty of Medicine, Siriraj Hospital, Mahidol University, Bangkok, Thailand
    • ,
  • N. Premasathian

      Affiliations

    • Renal Unit, Department of Medicine, Faculty of Medicine, Siriraj Hospital, Mahidol University, Bangkok, Thailand
    • ,
  • C. Shayakul

      Affiliations

    • Renal Unit, Department of Medicine, Faculty of Medicine, Siriraj Hospital, Mahidol University, Bangkok, Thailand
    • ,
  • P. Parichatikanond

      Affiliations

    • Department of Pathology, Faculty of Medicine, Siriraj Hospital, Mahidol University, Bangkok, Thailand

References 

  1. Feucht HE, Schneeberger H, Hillebrand G, et al. Capillary deposition of C4d complement fragment and early renal graft loss. Kidney Int. 1993;43:1333
  2. Lederer SR, Kluth-Pepper B, Schneeberger H, et al. Impact of humoral alloreactivity early after transplantation on the long-term survival of renal allografts. Kidney Int. 2001;59:334
  3. Michaels PJ, Fishbein MC, Colvin RB. Humoral rejection of human organ transplants. Springer Semin Immunopathol. 2003;25:119
  4. Colvin RB. Antibody-mediated renal allograft rejection: diagnosis and pathogenesis. J Am Soc Nephrol. 2007;18:1046
  5. Collins AB, Schneeberger EE, Pascual MA, et al. Complement activation in acute humoral renal allograft rejection: diagnostic significance of C4d deposits in peritubular capillaries. J Am Soc Nephrol. 1999;10:2208
  6. Crespo M, Pascual M, Tolkoff-Rubin N, et al. Acute humoral rejection in renal allograft recipients: I. Incidence, serology and clinical characteristics. Transplantation. 2001;71:652
  7. Watschinger B, Pascual M. Capillary C4d deposition as a marker of humoral immunity in renal allograft rejection. J Am Soc Nephrol. 2002;13:2420
  8. Bohmig GA, Exner M, Habicht A, et al. Capillary C4d deposition in kidney allografts: a specific marker of alloantibody-dependent graft injury. J Am Soc Nephrol. 2002;13:1091
  9. Solez K, Colvin RB, Racusen LC, et al. Banff 07 classification of renal allograft pathology: updates and future directions. Am J Transplant. 2008;8:753
  10. Lorenz M, Regele H, Schillinger M, et al. Risk factors for capillary C4d deposition in kidney allografts: evaluation of a large study cohort. Transplantation. 2004;78:447
  11. Herzenberg AM, Gill JS, Djurdjev O, et al. C4d deposition in acute rejection: an independent long-term prognostic factor. J Am Soc Nephrol. 2002;13:234
  12. Mauiyyedi S, Pelle PD, Saidman S, et al. Chronic humoral rejection: identification of antibody-mediated chronic renal allograft rejection by C4d deposits in peritubular capillaries. J Am Soc Nephrol. 2001;12:574
  13. Nickeleit V, Zeiler M, Gudat F, et al. Detection of the complement degradation product C4d in renal allografts: diagnostic and therapeutic implications. J Am Soc Nephrol. 2002;13:242
  14. Regele H, Exner M, Watschinger B, et al. Endothelial C4d deposition is associated with inferior kidney allograft outcome independently of cellular rejection. Nephrol Dial Transplant. 2001;16:2058
  15. Haas M, Rahman MH, Racusen LC, et al. C4d and C3d staining in biopsies of ABO- and HLA-incompatible renal allografts: Correlation with histologic findings. Am J Transplant. 2006;6:1829
  16. Mengel M, Bogers J, Bosmans JL, et al. Incidence of C4d stain in protocol biopsies from renal allografts: results from a multicenter trial. Am J Transplant. 2005;5:1050
  17. Jeong HJ, Kim SH, Kim YS, et al. Peritubular capillary C4d deposition in chronic allograft dysfunction. Yonsei Med J. 2004;45:859
  18. Ranjan P, Nada R, Jha V, et al. The role of C4d immunostaining in the evaluation of the causes of renal allograft dysfunction. Nephrol Dial Transplant. 2008;23:1735
  19. Racusen LC, Solez K, Colvin RB, et al. The banff 97 working classification of renal allograft pathology. Kidney Int. 1999;55:713
  20. Magil AB, Tinckam KJ. Focal peritubular capillary C4d deposition in acute rejection. Nephrol Dial Transplant. 2006;21:1382
  21. Mauiyyedi S, Crespo M, Collins AB, et al. Acute humoral rejection in kidney transplantation: II. Morphology, immunopathology, and pathologic classification. J Am Soc Nephrol. 2002;13:779
  22. Seemayer CA, Gaspert A, Nickeleit V, et al. C4d staining of renal allograft biopsies: a comparative analysis of different staining techniques. Nephrol Dial Transplant. 2007;22:568
  23. Troxell ML, Weintraub LA, Higgins JP, et al. Comparison of C4d immunostaining methods in renal allograft biopsies. Clin J Am Soc Nephrol. 2006;1:583
  24. Haas M, Kraus ES, Samaniego-Picota M, et al. Acute renal allograft rejection with intimal arteritis: histologic predictors of response to therapy and graft survival. Kidney Int. 2002;61:1516
  25. Choi J, Cho YM, Yang WS, et al. Peritubular capillary C4d deposition and renal outcome in post-transplant IgA nephropathy. Clin Transplant. 2007;21:159
  26. Regele H, Bohmig GA, Habicht A, et al. Capillary deposition of complement split product C4d in renal allografts is associated with basement membrane injury in peritubular and glomerular capillaries: a contribution of humoral immunity to chronic allograft rejection. J Am Soc Nephrol. 2002;13:2371
  27. Halloran PF, Wadgymar A, Ritchie S, et al. The significance of the anti-class I antibody response (I. Clinical and pathologic features of anti-class I-mediated rejection). Transplantation. 1990;49:85
  28. Trpkov K, Campbell P, Pazderka F, et al. Pathologic features of acute renal allograft rejection associated with donor-specific antibody, analysis using the banff grading schema. Transplantation. 1996;61:1586
  29. Magil AB, Tinckam K. Monocytes and peritubular capillary C4d deposition in acute renal allograft rejection. Kidney Int. 2003;63:1888
  30. Fahim T, Bohmig GA, Exner M, et al. The cellular lesion of humoral rejection: predominant recruitment of monocytes to peritubular and glomerular capillaries. Am J Transplant. 2007;7:385
  31. Regele H, Bohmig GA, Habicht A, et al. Capillary deposition of complement split product C4d in renal allografts is associated with basement membrane injury in peritubular and glomerular capillaries: a contribution of humoral immunity to chronic allograft rejection. J Am Soc Nephrol. 2002;13:2371

 This study was supported by a research development grant from the Faculty of Medicine, Siriraj Hospital, Mahidol University, Bangkok, Thailand.

PII: S0041-1345(09)01428-6

doi: 10.1016/j.transproceed.2009.04.015

Transplantation Proceedings
Volume 41, Issue 9 , Pages 3697-3700 , November 2009

Article Tools