Infiltrating Cell Types in Transplant Glomerulitis: Relationship to Peritubular Capillary C4d Deposition

Magil, Alex B.

doi:10.1053/j.ajkd.2005.02.017

Cited by 44 publications

(48 citation statements)

References 26 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…Moreover, presence of focal or diffuse C4d deposits was associated with macrophage/monocyte infiltrates, whereas T cells predominated when no C4d deposits were detected (Magil 2005;Magil and Tinckam 2006). These results were confirmed by Fahim et al (2007), who showed an abundant recruitment of monocytes to peritubular and glomerular capillaries during humoral rejection.…”

supporting

confidence: 74%

Effector Mechanisms of Rejection

Moreau

Varey

Anegón

et al. 2013

Cold Spring Harbor Perspectives in Medicine

144

136

View full text Add to dashboard Cite

supporting

confidence: 74%

Effector Mechanisms of Rejection

Moreau

Varey

Anegón

et al. 2013

Cold Spring Harbor Perspectives in Medicine

144

136

View full text Add to dashboard Cite

“…Several recent studies have suggested an association of glomerulitis with AMR and PTC C4d deposition, and that glomerulitis may serve as a surrogate marker for AMR, although the assessment of glomerulitis is not currently considered in the grading and diagnosis of any rejection episodes (27)(28)(29)(30)(31)(32). While the numbers are small, our histologic analysis also shows a closer association between glomerulitis and C4d staining in ABO-C grafts than that of ABO-I grafts.…”

Section: Discussionmentioning

confidence: 62%

Analysis of Renal Transplant Protocol Biopsies in ABO-Incompatible Kidney Transplantation

Setoguchi

Ishida

Shimmura

et al. 2008

American Journal of Transplantation

View full text Add to dashboard Cite

All contributing authors have declared that there is no relationship with any companies and no conflict of interest in this study.Numerous studies have shown that protocol biopsies have predictive power. We retrospectively examined the histologic findings and C4d staining in 89 protocol biopsies from 48 ABO-incompatible (ABO-I) transplant recipients, and compared the results with those of 250 controls from 133 ABO-compatible (ABO-C) transplant recipients given equivalent maintenance immunosuppression. Others have shown that subclinical rejection (borderline and grade I) in ABO-C grafts decreased gradually after transplantation. In our study, however, subclinical rejection in the ABO-I grafts was detected in 10%, 14% and 28% at 1, 3 and 6-12 months, respectively. At 6-12 months, mild tubular atrophy was more common in the ABO-C grafts whereas the incidence of transplant glomerulopathy did not differ between the two groups (ABO-C: 7%; ABO-I: 15%; p = 0.57). In the ABO-I transplants, risk factors for transplant glomerulopathy in univariate analysis were positive panel reactivity (relative risk, 45.0; p < 0.01) and a prior history of antibody-mediated rejection (relative risk, 17.9; p = 0.01). Furthermore, C4d deposition in the peritubular capillaries was detected in 94%, with diffuse staining in 66%. This deposition, however, was not linked to antibody-mediated rejection. We conclude that, in the ABO-I kidney transplantation setting, detection of C4d alone in protocol biopsies might not have any diagnostic or therapeutic relevance.

show abstract

“…While glomerulitis is not currently integrated into the Banff grading schema for the diagnosis of T cell-mediated rejection (TCMR) (4), it is recognized as a component of antibody-mediated rejection (AMR) (3). The work by Magil and coworkers (5)(6)(7) suggests that intraglomerular capillary macrophages accumulate in AMR while T cells predominate in TCMR.…”

Section: Introductionmentioning

confidence: 99%

“…In addition to glomerular inflammation, some authors stress the concurrent enlargement of endothelial cells (4), while others suggest a need to demonstrate endocapillary occlusive lesions (8,9). Several studies have attempted to investigate the significance of transplant glomerulitis (Table 1) (2,(5)(6)(7)(8)(10)(11)(12)(13). Many of these studies lacked a precise definition of this lesion.…”

Section: Introductionmentioning

confidence: 99%

A Critical Appraisal of Methods to Grade Transplant Glomerulitis in Renal Allograft Biopsies

Batal

Lunz

Aggarwal

et al. 2010

American Journal of Transplantation

View full text Add to dashboard Cite

Transplant glomerulitis is an increasingly recognized lesion in renal transplant biopsies. To develop a refined grading system, we defined glomerulitis by the presence of ≥5 leukocytes/glomerulus and evaluated 111 biopsies using three different grading systems: (i) percentage of glomerular involvement, (ii) peak inflammation in the most severely affected glomerulus and (iii) presence/absence of endocapillary occlusion by inflammatory cells. Endocapillary occlusion had no impact on graft survival, but was associated with increased serum creatinine, proteinuria and subsequent transplant glomerulopathy. Grading based on either percent or peak glomerular involvement correlated with graft failure and peritubular capillaritis. However, the percent glomerular involvement method had the additional advantage of displaying associations with: concurrent proteinuria, focal or diffuse immunoperoxidase peritubular capillary C4d staining, 1-year postbiopsy serum creatinine, subsequent detection of donor-specific antibody and development of transplant glomerulopathy. Patients with >75% glomerular involvement also revealed persistent high-grade glomerulitis on follow-up biopsies despite antirejection treatment. In conclusion, grading of glomerulitis is a meaningful exercise, and a quantification system based on percentage of glomerular involvement shows the most robust associations with clinical parameters and prognosis.

show abstract

Infiltrating Cell Types in Transplant Glomerulitis: Relationship to Peritubular Capillary C4d Deposition

Cited by 44 publications

References 26 publications

Effector Mechanisms of Rejection

Effector Mechanisms of Rejection

Analysis of Renal Transplant Protocol Biopsies in ABO-Incompatible Kidney Transplantation

A Critical Appraisal of Methods to Grade Transplant Glomerulitis in Renal Allograft Biopsies

Contact Info

Product

Resources

About