CD20 Expression in the Transplanted Kidney of Patients with Graft Loss and Transient Allograft Dysfunction

Abstract

Summary: This study aimed to explore the relationship between the infiltration of CD20+ B cells and the survival time of a renal allograft and to investigate the role of infiltrated B cells in the rejection of the renal allograft. A total of 40 patients with renal allograft loss due to refractory rejection and 20 patients with transient renal allograft dysfunction were recruited. Renal biopsy was done and CD20 expression was detected by immunohistochemistry. In addition, the survival time of the renal allograft was also obtained. The relationships between the CD20 expression and the survival time of the renal allograft and graft loss due to rejection were analyzed. The associations of gender, age and clinicopathogical types with the CD20 expression were also investigated. The proportion of patients positive for CD20 in the transplanted kidney was higher in patients receiving nephrectomy of the allograft due to rejection than in those with transient allograft dysfunction. The diffuse infiltration of CD20+ B cells was considered as positive staining. In 40 samples from patients with graft loss, 19 had diffuse infiltration of CD20+ B cells (47.5%). In 19 patients positive for CD20, hyperacute rejection was found in 1 patient, acute rejection in 5 and chronic rejection in 13. Statistical analysis showed the CD20 expression was not associated with the age and gender of donors and recipients, regimen for immunosuppressive treatment, cold/warm ischemia time and secondary transplantation. CD20+ B cell infiltration predicts a poor prognosis of patients with kidney transplantation and is one of the risk factors of graft loss. Keywords: renal allograft, rejection, CD20, B cellsKratak sadr`aj: Cilj ove studije bio je da se ispita odnos izme|u infiltracije CD20+ B }elija i vremena pre`ivljavanja bubre`nog alografta, kao i da se istra`i uloga infiltriranih B }elija u odbacivanju bubre`nog alografta. Obuhva}eno je ukupno 40 pacijenata sa gubitkom bubre`nog alografta usled refraktornog odbacivanja i 20 pacijenata sa prolaznom disfunkcijom bubre`nog alografta. Izvr{ena je biopsija bubrega a ekspresija CD20 detektovana je imunohistohemijski. Pored toga, utvr|eno je vreme pre`ivljavanja bubre`nog alografta. Analizirani su odnosi izme|u ekspresije CD20 i vremena pre`ivljavanja bubre`nog alografta i gubitka grafta usled odbacivanja. Tako|e je ispitana povezanost pola, uzrasta i klini~ko-patolo{kih tipova i ekspresije CD20. Propor cionalno vi{e pacijenata kod kojih je na|ena ekspresija CD20 u presa|enom bubregu bilo je me|u pacijentima podvrgnutim nefrektomiji alografta usled odbacivanja nego me|u onima sa prolaznom disfunkcijom alografta. Difuzna infiltracija CD20+ B }elija ozna~ena je kao pozitivno bojenje. Od 40 uzo raka od pacijenata sa gubitkom grafta, kod 19 je otkrivena difuzna infiltracija CD20+ B }elija (47,5 %). Od 19 pacijenata pozitivnih na CD20, kod 1 je prona|eno hiperakutno odbacivanje, kod 5 akutno odbacivanje a hroni~no odbacivanje kod 13 subjekata. Statisti~ka analiza je pokazala da ekspresija CD20 nije povezana sa ...