Pathological and immunological changes of renal transplant rejection:report of 56 cases
10.3969/j.issn.1673-4254.2014.03.10
- VernacularTitle:移植肾排异反应的病理及免疫学改变：附56例报告
- Author:
Yanxia SUI
1
;
Tao SUN
;
Dongli ZHAO
;
Jun HOU
;
Xiaofeng LI
;
Zhe YANG
Author Information
1. 西安交通大学医学院第一附属医院病理科
- Keywords:
kidney transplant;
biopsy;
immunohistochemistry;
graft rejection;
pathology
- From:
Journal of Southern Medical University
2014;(3):341-344
- CountryChina
- Language:Chinese
-
Abstract:
Objective To investigate the pathological and immunological changes of renal grafts in recipients experiencing graft rejection. Methods The clinicopathologic data of 56 renal needle biopsy samples obtained from renal transplant recipients were analyzed retrospectively. The specimens were classified histopathologically according to the Banff 2009 classification system and analyzed by immunohistochemical labeling and immunofluorescence. Results In the 56 recipients, 1 (1.79%) experienced hyperacute rejection, 8 (14.29%) had suspected acute rejection, 12 (21.43%) developed acute T-cell rejection, 6 (10.71%) had acute antibody-mediated rejection, 2 (3.57%) had acute T-cell rejection with acute antibody-mediated rejection, 12 (21.43%) had chronic active T cell-mediated rejection, 2 (3.57%) had chronic active antibody-mediated rejection, 2 (3.57%) had chronic active T cell-mediated rejection with antibody-mediated rejection, 8 (14.29%) had non-specific interstitial fibrosis and tubular atrophy, and 3 (5.36%) had normal graft function. The expression levels of immune markers CD3, CD4, CD8, CD20, GrB and perforin differed with the types of T cell-mediated graft rejection, and the positivity and expression levels of these markers tended to increased with the severity of graft rejection. The expression of C4d was positive in all cases with antibody-mediated graft rejection. Conclusion The pathological characteristics of the renal biopsy specimens and expression levels of the immune markers allow timely and accurate evaluation of graft rejection type to provide a reliable pathological and etiological basis for clinical treatment and prognostic assessment.
