Clinical implication of complement split product C4d in patients with antibody-mediated chronic rejection
10.3760/cma.j.issn.0254-1785.2010.06.003
- VernacularTitle:C4d沉积在抗体介导的慢性排斥反应中的临床意义
- Author:
Junqi GUO
;
Fuqiang HE
;
Zhiyong ZHENG
;
Weizhen WU
;
Shunliang YANG
;
Yinghao YU
;
Jianming TAN
- Publication Type:Journal Article
- Keywords:
Complement C4;
Graft rejection;
Immunohistochemistry
- From:
Chinese Journal of Organ Transplantation
2010;31(6):328-331
- CountryChina
- Language:Chinese
-
Abstract:
Objective To explore the significance of peritubular capillary C4d deposition in histopathological changes, renal function and prognosis of the patients with antibody-mediated chronic rejection (AMCR). Methods Deposition of C4d in the kidney was examined by irnmunohistochemistry on routine paraffin-embedded sections using anti-C4d polyclonal antibody. Seventy-seven patients were divided into C4d+ group (n = 35) and C4d- group (n = 42). The relationship of C4d and renal function,histopathological changes and prognoses of allografts were analyzed. Results The number of patients with tubular atrophy and glomerular basement membrane proliferation in C4d+ group was significantly more than that in C4d group (P＜0.05). Mean serum creatinine level was significantly higher in C4d+ group than in C4d- group 12 months after renal transplantation [(379.1 + 260.2)μmol/L vs (260.5 + 175.3) μmol/L, P＜0.05]. According to Kaplan-Meier analysis, the one-year graft survival rate was lower in the C4d+ group (62.9% ) than in the C4d- group (83.3% ) (logrank P＜0.05). Conclusion Patients with C4d deposition are associated with tubular atrophy and glomerular basement membrane proliferation. The serum creatinine level in C4d+ patients was significantly higher than in C4d- group at the 12th month after transplantation. More patients with C4d deposition lost their grafts during the study period.
