Pathologic characteristics of acute humoral rejection after abo-incompatible kidney transplantation

Morozumi, Kunio; Katoh, Masahito; Horike, Keiji; Oikawa, Tadashi; Takeuchi, O; Kimura, Genjiro; Takeda, Asami; Yoshida, Atsuhiro; Katayama, Akio; Tominaga, Yoshihiro; Haba, T; Uchida, Kazuharu

doi:10.1016/s0041-1345(01)02401-0

Cited by 8 publications

(7 citation statements)

References 5 publications

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“…Moreover, the weak‐positive specimens showed an obvious intensity compared with their 0 h biopsy specimens. A previous report has suggested that no PTC deposition of C4d can be noted following 0 h and 1 h biopsy in ABO‐incompatible renal transplant grafts (4), although they regarded only diffuse strongly positive stains in PTC as positive. We presume that their stringent positive‐staining criteria led them to a different result from ours.…”

Section: Discussionmentioning

confidence: 97%

“…C4d deposition in the PTC of ABO‐incompatible kidney grafts may be regarded as less critical than that of ABO‐compatible kidney grafts. However, some reports have suggested that in cases of ABO‐incompatible renal transplantation, a majority of the graft biopsy specimens with acute humoral rejection showed a strong positive C4d deposition in the PTC, and that the depositions were more intense than those of graft biopsy specimens without acute humoral rejection (4).…”

Section: Discussionmentioning

confidence: 99%

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C4d and/or immunoglobulins deposition in peritubular capillaries in perioperative graft biopsies in ABO‐incompatible renal transplantation

Kanetsuna

Yamaguchi

Horita

et al. 2004

Clinical Transplantation

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We evaluated 0 h and/or 1 h graft biopsy specimens from 14 recipients in ABO-incompatible renal transplantation using immunofluorescence for C4d, IgG, and IgM. All 0 h biopsy specimens revealed negative C4d, IgG, and IgM deposition in peritubular capillaries (PTC). In contrast, 8 of 14 1 h biopsy specimens revealed a positive C4d deposition in PTC. Eight specimens revealed positive IgM staining and seven of them had both C4d and IgM depositions. Three specimens had C4d, IgM, and IgG depositions in PTC. Three of eight patients with C4d deposition and two of six patients without C4d deposition in the 1 h biopsy group suffered from acute rejection within 1 month of transplantation. These findings suggest that complement fragments and immunoglobulin deposition in PTC in ABO-incompatible renal grafts can start soon after reperfusion, although acute rejection may or may not develop.

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Section: Discussionmentioning

confidence: 97%

Section: Discussionmentioning

confidence: 99%

C4d and/or immunoglobulins deposition in peritubular capillaries in perioperative graft biopsies in ABO‐incompatible renal transplantation

Kanetsuna

Yamaguchi

Horita

et al. 2004

Clinical Transplantation

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“…West demonstrated absence of intragraft deposition of immunoglobulins and complement components in pediatric heart transplant patients [3]. Morozumi et al also reported that immunofluorescent microscopy, revealed no significant deposition of IgG and IgM; and ordinary complements of C1q, C3 and C4 in all materials, even with severe acute humoral rejection [4]. Production of anti-donor antibodies could be specifically suppressed in long-term ABO-incompatible kidney transplant recipients.…”

Section: Resultsmentioning

confidence: 99%

Donor-specific suppression of blood group antibodies in ABO-incompatible kidney transplantation

Aikawa

Ohara

Yamashita

et al. 2006

International Congress Series

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“…Haas et al (33) found no correlation between cold ischemia time and C4d deposition in 1‐h postreperfusion biopsies, but this may be owing to the early timing of the biopsies. Morozumi et al also reported that there was no C4d deposition at 1 h postreperfusion, but found good correlation between complement deposition and AHR at later time points (34). Therefore, this phenomenon may play a role in human renal allotransplantation, especially with longer hypothermia times.…”

Section: Discussionmentioning

confidence: 99%

Prolonged Hypothermia Causes Primary Nonfunction in Preserved Canine Renal Allografts due to Humoral Rejection

Gilligan¹,

Woo²,

Kosieradzki³

et al. 2004

American Journal of Transplantation

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Canine kidney preservation models have historically used autotransplants to avoid the complications of rejection, although clinically all transplants are allografts. This study investigated the effects of preservation time and method on early kidney function in a canine allograft vs. autograft model. Kidneys were harvested from beagles, preserved by cold storage (CS) in UW solution for 0, 24 or 72 h, or by machine perfusion (MP) with Belzer MPS for 72 h. In some experiments 45 min of warm ischemia (WI) was performed in situ before harvest. Allograft recipients received steroid immunosuppression. Kidney function was assessed by serum creatinine and survival for 7 days. Allografts preserved for 0 and 24 h performed as well as autografts. Allografts preserved for 72 h by either CS or MP had a higher incidence of primary nonfunction (PNF) compared with autografts, as determined by survival (50% vs. 100%, p < 0.003). Primary nonfunction kidneys had thrombotic microangiopathy, vascular and peritubular capillary binding of IgM and complement C4d, and evidence of circulating donor-specific antibodies; all consistent with humoral rejection. These responses were dependant on hypothermia time and were not attributable to ischemia, immunosuppression, preservation solution, or cellular rejection. In conclusion, prolonged hypothermia can cause PNF in allografts owing to acute humoral rejection.

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Pathologic characteristics of acute humoral rejection after abo-incompatible kidney transplantation

Cited by 8 publications

References 5 publications

C4d and/or immunoglobulins deposition in peritubular capillaries in perioperative graft biopsies in ABO‐incompatible renal transplantation

C4d and/or immunoglobulins deposition in peritubular capillaries in perioperative graft biopsies in ABO‐incompatible renal transplantation

Donor-specific suppression of blood group antibodies in ABO-incompatible kidney transplantation

Prolonged Hypothermia Causes Primary Nonfunction in Preserved Canine Renal Allografts due to Humoral Rejection

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