Transplant glomerulopathy may occur in the absence of donor-specific antibody and C4d staining

Enver Akalin, Rajani Dinavahi, Steven Dikman, Graciela de Boccardo, Rex Friedlander, Bernd Schroppel, Vinita Sehgal, Jonathan S. Bromberg, Peter Heeger, Barbara Murphy

Research output: Contribution to journalArticle

48 Citations (Scopus)

Abstract

Background and objectives: Transplant glomerulopathy (TGP) has been proposed to be a component of chronic antibody-mediated rejection (AMR). We have studied 36 patients with TGP and 51 patients with chronic allograft nephropathy (CAN) but without TGP for C4d staining and donor-specific anti-HLA antibodies (DSA) to investigate the alloantibody-mediated mechanisms. Design, setting, participants, & measurements: Allograft biopsies were stained with C4d staining and DSAs were studied by Luminex Flow Beads. Allograft biopsies were done at a mean of 5.3 ± 5.0 and 5.6 ± 4.6 yr after transplantation in patients with CAN and TGP, respectively. Results: The mean creatinine level at the time of the biopsy was 2.7 ± 1.2 mg/dl in each group. Proteinuria of >1.0 g/d was more common in patients with TGP (61 versus 25%; P = 0.002). Whereas three patients with TGP had a history of acute AMR, none of the patients with CAN had. Mean chronicity score of the biopsies were 1.7 ± 0.7 in patients with CAN and 1.9 ± 0.8 in patients with TGP. Biopsies from only two (4%) patients with CAN and four (11%) patients with TGP had diffuse C4d positivity. DSA were found in 36% of TGP and 33% of CAN patients. Conclusions: These results suggest that a substantial number of patients with TGP did not have positive C4d staining or DSA, indicating that a non-alloantibody-mediated process may be involved in the development of TGP in some patients.

Original languageEnglish (US)
Pages (from-to)1261-1267
Number of pages7
JournalClinical Journal of the American Society of Nephrology
Volume2
Issue number6
DOIs
StatePublished - Nov 2007
Externally publishedYes

Fingerprint

Tissue Donors
Staining and Labeling
Transplants
Antibodies
Allografts
Biopsy
Anti-Idiotypic Antibodies
Isoantibodies
Proteinuria
Creatinine
Transplantation

ASJC Scopus subject areas

  • Nephrology
  • Transplantation
  • Epidemiology
  • Critical Care and Intensive Care Medicine
  • Medicine(all)

Cite this

Transplant glomerulopathy may occur in the absence of donor-specific antibody and C4d staining. / Akalin, Enver; Dinavahi, Rajani; Dikman, Steven; de Boccardo, Graciela; Friedlander, Rex; Schroppel, Bernd; Sehgal, Vinita; Bromberg, Jonathan S.; Heeger, Peter; Murphy, Barbara.

In: Clinical Journal of the American Society of Nephrology, Vol. 2, No. 6, 11.2007, p. 1261-1267.

Research output: Contribution to journalArticle

Akalin, E, Dinavahi, R, Dikman, S, de Boccardo, G, Friedlander, R, Schroppel, B, Sehgal, V, Bromberg, JS, Heeger, P & Murphy, B 2007, 'Transplant glomerulopathy may occur in the absence of donor-specific antibody and C4d staining', Clinical Journal of the American Society of Nephrology, vol. 2, no. 6, pp. 1261-1267. https://doi.org/10.2215/CJN.02420607
Akalin, Enver ; Dinavahi, Rajani ; Dikman, Steven ; de Boccardo, Graciela ; Friedlander, Rex ; Schroppel, Bernd ; Sehgal, Vinita ; Bromberg, Jonathan S. ; Heeger, Peter ; Murphy, Barbara. / Transplant glomerulopathy may occur in the absence of donor-specific antibody and C4d staining. In: Clinical Journal of the American Society of Nephrology. 2007 ; Vol. 2, No. 6. pp. 1261-1267.
@article{96e844ef6198497894facd39d981187f,
title = "Transplant glomerulopathy may occur in the absence of donor-specific antibody and C4d staining",
abstract = "Background and objectives: Transplant glomerulopathy (TGP) has been proposed to be a component of chronic antibody-mediated rejection (AMR). We have studied 36 patients with TGP and 51 patients with chronic allograft nephropathy (CAN) but without TGP for C4d staining and donor-specific anti-HLA antibodies (DSA) to investigate the alloantibody-mediated mechanisms. Design, setting, participants, & measurements: Allograft biopsies were stained with C4d staining and DSAs were studied by Luminex Flow Beads. Allograft biopsies were done at a mean of 5.3 ± 5.0 and 5.6 ± 4.6 yr after transplantation in patients with CAN and TGP, respectively. Results: The mean creatinine level at the time of the biopsy was 2.7 ± 1.2 mg/dl in each group. Proteinuria of >1.0 g/d was more common in patients with TGP (61 versus 25{\%}; P = 0.002). Whereas three patients with TGP had a history of acute AMR, none of the patients with CAN had. Mean chronicity score of the biopsies were 1.7 ± 0.7 in patients with CAN and 1.9 ± 0.8 in patients with TGP. Biopsies from only two (4{\%}) patients with CAN and four (11{\%}) patients with TGP had diffuse C4d positivity. DSA were found in 36{\%} of TGP and 33{\%} of CAN patients. Conclusions: These results suggest that a substantial number of patients with TGP did not have positive C4d staining or DSA, indicating that a non-alloantibody-mediated process may be involved in the development of TGP in some patients.",
author = "Enver Akalin and Rajani Dinavahi and Steven Dikman and {de Boccardo}, Graciela and Rex Friedlander and Bernd Schroppel and Vinita Sehgal and Bromberg, {Jonathan S.} and Peter Heeger and Barbara Murphy",
year = "2007",
month = "11",
doi = "10.2215/CJN.02420607",
language = "English (US)",
volume = "2",
pages = "1261--1267",
journal = "Clinical Journal of the American Society of Nephrology",
issn = "1555-9041",
publisher = "American Society of Nephrology",
number = "6",

}

TY - JOUR

T1 - Transplant glomerulopathy may occur in the absence of donor-specific antibody and C4d staining

AU - Akalin, Enver

AU - Dinavahi, Rajani

AU - Dikman, Steven

AU - de Boccardo, Graciela

AU - Friedlander, Rex

AU - Schroppel, Bernd

AU - Sehgal, Vinita

AU - Bromberg, Jonathan S.

AU - Heeger, Peter

AU - Murphy, Barbara

PY - 2007/11

Y1 - 2007/11

N2 - Background and objectives: Transplant glomerulopathy (TGP) has been proposed to be a component of chronic antibody-mediated rejection (AMR). We have studied 36 patients with TGP and 51 patients with chronic allograft nephropathy (CAN) but without TGP for C4d staining and donor-specific anti-HLA antibodies (DSA) to investigate the alloantibody-mediated mechanisms. Design, setting, participants, & measurements: Allograft biopsies were stained with C4d staining and DSAs were studied by Luminex Flow Beads. Allograft biopsies were done at a mean of 5.3 ± 5.0 and 5.6 ± 4.6 yr after transplantation in patients with CAN and TGP, respectively. Results: The mean creatinine level at the time of the biopsy was 2.7 ± 1.2 mg/dl in each group. Proteinuria of >1.0 g/d was more common in patients with TGP (61 versus 25%; P = 0.002). Whereas three patients with TGP had a history of acute AMR, none of the patients with CAN had. Mean chronicity score of the biopsies were 1.7 ± 0.7 in patients with CAN and 1.9 ± 0.8 in patients with TGP. Biopsies from only two (4%) patients with CAN and four (11%) patients with TGP had diffuse C4d positivity. DSA were found in 36% of TGP and 33% of CAN patients. Conclusions: These results suggest that a substantial number of patients with TGP did not have positive C4d staining or DSA, indicating that a non-alloantibody-mediated process may be involved in the development of TGP in some patients.

AB - Background and objectives: Transplant glomerulopathy (TGP) has been proposed to be a component of chronic antibody-mediated rejection (AMR). We have studied 36 patients with TGP and 51 patients with chronic allograft nephropathy (CAN) but without TGP for C4d staining and donor-specific anti-HLA antibodies (DSA) to investigate the alloantibody-mediated mechanisms. Design, setting, participants, & measurements: Allograft biopsies were stained with C4d staining and DSAs were studied by Luminex Flow Beads. Allograft biopsies were done at a mean of 5.3 ± 5.0 and 5.6 ± 4.6 yr after transplantation in patients with CAN and TGP, respectively. Results: The mean creatinine level at the time of the biopsy was 2.7 ± 1.2 mg/dl in each group. Proteinuria of >1.0 g/d was more common in patients with TGP (61 versus 25%; P = 0.002). Whereas three patients with TGP had a history of acute AMR, none of the patients with CAN had. Mean chronicity score of the biopsies were 1.7 ± 0.7 in patients with CAN and 1.9 ± 0.8 in patients with TGP. Biopsies from only two (4%) patients with CAN and four (11%) patients with TGP had diffuse C4d positivity. DSA were found in 36% of TGP and 33% of CAN patients. Conclusions: These results suggest that a substantial number of patients with TGP did not have positive C4d staining or DSA, indicating that a non-alloantibody-mediated process may be involved in the development of TGP in some patients.

UR - http://www.scopus.com/inward/record.url?scp=38449093287&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=38449093287&partnerID=8YFLogxK

U2 - 10.2215/CJN.02420607

DO - 10.2215/CJN.02420607

M3 - Article

VL - 2

SP - 1261

EP - 1267

JO - Clinical Journal of the American Society of Nephrology

JF - Clinical Journal of the American Society of Nephrology

SN - 1555-9041

IS - 6

ER -