Clinical Significance of C4d-Positivity in Renal Transplant Recipients with Acute Rejection.
- Author:
Byung Ha CHUNG
1
;
Hee Sun JUNG
;
Sang Hoon JEON
;
Yong Jai PARK
;
Son Ook CHOI
;
Jeong Min YOON
;
Bum Soon CHOI
;
Yeong Jin CHOI
;
Chul Woo YANG
;
Yong Soo KIM
;
Chang Suk KANG
;
Byung Kee BANG
Author Information
1. Department of Internal Medicine, College of Medicine, The Catholic University of Korea, Seoul, Korea. yangch@catholic.ac.kr
- Publication Type:Original Article
- Keywords:
Acute allograft rejection;
C4d;
Kidney transplantation
- MeSH:
Allografts;
Biopsy;
Capillaries;
Fluorescent Antibody Technique;
Graft Survival;
Humans;
Kidney;
Kidney Transplantation;
Transplantation*;
Transplants
- From:The Journal of the Korean Society for Transplantation
2005;19(2):137-141
- CountryRepublic of Korea
- Language:Korean
-
Abstract:
PURPOSE: C4d detection in peritubular capillaries in acute allograft rejection has been regarded as a poor prognostic factor for graft kidney survival. We investigated the clinical importance of C4d positivity in renal transplant recipients with acute rejection. METHODS: Forty eight renal allograft biopsies were selected, which were available for immunofluorescence study. The samples were divided into two groups, one which was diagnosed as acute rejection clinically (n=30), the other which underwent protocol biopsy 2 weeks after transplantation (n=18). Among the acute rejection group, C4d staining was positive in 50% of acute rejection cases (C4d (+), n=15) and negative in the others. (C4d (-), n=15). We compared the C4d (+) group and the C4d (-) group in terms of clinical parameters and graft survival duration. RESULTS: Renal function was reduced in the C4d (+) group compared to the C4d (-) group. In the C4d (+) group, 8 of 15 cases resulted in graft loss, but only one graft loss developed in the C4d (-) group. Graft survival duration after kidney biopsy was reduced in the C4d (+) group compared to the C4d (-) group. CONCLUSION: Renal transplant recipient with C4d-positive acute rejection shows inferior graft survival duration. So tight management in addition to steroid pulse therapy should be considered for these patients.
