C4D Deposition and Positive Posttransplant Crossmatch Are Not Necessarily Markers of Antibody-Mediated Rejection in Renal Allograft Recipients

摘要: Abstract The aim of the study was to search for serologic, immunopathologic, and morphologic evidence antibody-mediated rejection (AMR) among patients with acute renal allograft dysfunction. included 19 episodes (ARE) within first year after transplantation. All had negative crossmatch tests before Patients underwent biopsy histologic C4d examinations. were monitored donor-specific HLA alloantibodies during posttransplant year. Complement-dependent cytotoxic crossmatches performed donor lymphocytes. In eight patients, test results changed positive ARE. all biopsies except one cortical infarction, we observed staining (group 1). four showed changes AMR, their grafts lost. patient, cellular vascular (Banff II) present; in two, Banff I; one, borderline lesions. These compared 11 ARE but 2). findings these interstitial I II). With no features suggestive AMR. During transplantation, creatinine levels group 1 significantly higher than 2 patients. One-year graft survival 50% 91% 2. Conclusions a not associated AMR half Nevertheless, deposition correlated injury transplant