Preceding T-Cell-Mediated Rejection Is Associated with the Development of Chronic Active Antibody-Mediated Rejection by de Novo Donor-Specific Antibody
| Autor: | Naomichi Ishidate, Takahiro Tsuji, Keishi Makita, Yuichiro Fukazawa, Teppei Imamoto, Nobuyuki Fukuzawa, Akihiko Mitsuke, Hiroshi Harada, Sari Iwasaki |
|---|---|
| Rok vydání: | 2020 |
| Předmět: |
Adult
Graft Rejection Male medicine.medical_specialty Time Factors T cell T-Lymphocytes 030232 urology & nephrology 030204 cardiovascular system & hematology Gastroenterology Peritubular capillaries 03 medical and health sciences Young Adult 0302 clinical medicine Isoantibodies Internal medicine medicine Humans biology Chronic Active business.industry Donor specific antibodies Middle Aged Kidney Transplantation Tissue Donors Transplantation medicine.anatomical_structure Antibody mediated rejection Chronic Disease Renal allograft biology.protein Female Antibody business |
| Zdroj: | Nephron. 144 |
| ISSN: | 2235-3186 |
| Popis: | Aim: Chronic active antibody-mediated rejection (CAABMR) is an important cause of late-stage renal allograft loss. Early inflammatory events such as acute rejection and infection after transplantation are considered to be the risk factors of de novo donor-specific antibody (dnDSA) production. In this study, we investigated the relationship between predisposing T-cell-mediated rejection and dnDSA-positive CAABMR. Methods: We recruited 365 patients who underwent ABO-compatible renal transplantation at our hospital. Among them, 16 patients diagnosed as having dnDSA-positive CAABMR were designated as a CAABMR group, and 38 randomly selected patients were designated as a control group. All biopsies from 1 month after transplantation were included in the study. The presence or absence of borderline changes (BLCs), acute T-cell-mediated rejection (ATMR), microvascular inflammation (MVI), and C4d positive on peritubular capillaries (C4d-P) was examined. Results: In the CAABMR group, BLC/ATMR was found in 12 cases (75%), and the mean duration until appearance of BLC/ATMR was 282.7 ± 328.7 days. C4d-P was found in 11 cases (68.8%), and the mean duration until its appearance was 1,432 ± 1,307 days. MVI was found in all cases, and the mean duration until its appearance was 1,333 ± 1,126 days. The mean duration until diagnosis of CAABMR was 2,268 ± 1,191 days. In the control group, BLC/ATMR was found in 13 cases (34.2%), and the mean duration until the appearance of BLC/ATMR was 173.1 ± 170.4 days. C4d-P was found in 2 cases (5.3%), and the durations until its appearance were 748 and 1,881 days. No cases of MVI were found in the control group. The frequency of BLC/ATMR was significantly higher in the CAABMR group (p < 0.01). Conclusion: Preceding BLC/ATMR is associated with the development of CAABMR with dnDSA. |
| Databáze: | OpenAIRE |
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