Specific humoral rejection of a pancreas allograft in a recipient of pancreas after kidney transplantation

Carbajal, Roger; Karam, Georges; Renaudin, Karine; Maillet, Frédéric; Cesbron, Anne; Rostaing, Lionel; Cantarovich, Diego; Soulillou, Jean‐Paul; Blancho, Gilles

doi:10.1093/ndt/gfl729

Cited by 21 publications

(20 citation statements)

References 8 publications

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“…Although the association of female gender with graft loss was previously reported in a registry-based study, 5 all cases of pancreas AMR published to date have occurred in men. 20,21 In addition to female gender, a high donor serum creatinine was an independent risk factor for both kidney and pancreas graft loss. This finding is not surprising because it is widely known that donor age and donor kidney function are closely related to graft survival after SPK transplantation.…”

Section: Discussionmentioning

confidence: 99%

“…20,21 The first one was a 44-yr-old male patient who developed kidney AMR early after SPK transplantation, 7 yr after first isolated deceased-donor kidney transplantation. After intensive treatment and during kidney allograft function recovery, pancreas function began to deteriorate and a biopsy showed diffuse C4d staining in the interacinar capillaries.…”

Section: Discussionmentioning

confidence: 99%

“…21 Notably, both AMR cases developed despite intense induction therapy with Thymoglobulin and maintenance immunosuppression with tacrolimus, MMF, and steroids. In both cases, diffuse C4d deposition in interacinar capillaries was shown by immunofluorescence.…”

Section: Discussionmentioning

confidence: 99%

“…10 -16 In addition, AMR is a widely known complication after heart transplantation, 11,17 and isolated reports suggested that it may also affect the transplanted lung, 18 the liver, 19 or the pancreas. 20,21 No studies have assessed the prevalence and significance of AMR after SPK transplantation.…”

mentioning

confidence: 99%

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Antibody-Mediated Rejection of the Kidney after Simultaneous Pancreas-Kidney Transplantation

Pascual¹,

Samaniego²,

Torrealba³

et al. 2008

Journal of the American Society of Nephrology

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The prevalence, risk factors, and outcome of antibody-mediated rejection (AMR) of the kidney after simultaneous pancreas-kidney transplantation are unknown. In 136 simultaneous pancreas-kidney recipients who were followed for an average of 3.1 yr, 21 episodes of AMR of the kidney allograft were identified. Eight episodes occurred early (Յ90 d) after transplantation, and 13 occurred later. Histologic evidence of concomitant acute cellular rejection was noted in 12 cases; the other nine had evidence only of humoral rejection. In 13 cases, clinical rejection of the pancreas was diagnosed simultaneously, and two of these were biopsy proven and were positive for C4d immunostaining. Multivariate analysis identified only one significant risk factor: Female patients were three times more likely to experience AMR. Nearly all early episodes resolved with treatment and did not predict graft loss, but multivariate Cox models revealed that late AMR episodes more than tripled the risk for kidney and pancreas graft loss; therefore, new strategies are needed to prevent and to treat late AMR in simultaneous pancreaskidney transplant recipients.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

mentioning

confidence: 99%

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Antibody-Mediated Rejection of the Kidney after Simultaneous Pancreas-Kidney Transplantation

Pascual¹,

Samaniego²,

Torrealba³

et al. 2008

Journal of the American Society of Nephrology

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“…Pancreas Allograft C4d Staining and Interpretation.-After initial case reports of ABMR in pancreas allografts from several groups, [56][57][58] Torrealba and colleagues 59 published the first study systematically investigating C4d staining in correlation with donor-specific antibody studies, histopathology, treatment, and outcome. In their series of 27 biopsies from 18 patients whose C4d was stained with a formalin/IHC-IP method, they reported that C4d staining in interacinar capillaries (5% or more of capillaries staining) correlated with the presence of donor-specific antibodies, and that C4d labeling of arteries, veins, interstitial structures, or islets did not.…”

Section: 51mentioning

confidence: 99%

Practical Applications in Immunohistochemistry: Evaluation of Rejection and Infection in Organ Transplantation

Troxell¹,

Lanciault

2016

Archives of Pathology &Amp; Laboratory Medicine

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Context.-Immunohistochemical analysis of tissue biopsy specimens is a crucial tool in diagnosis of both rejection and infection in patients with solid organ transplants. In the past 15 years, the concept of antibody-mediated rejection has been refined, and diagnostic criteria have been codified in renal, heart, pancreas, and lung allografts (with studies ongoing in liver, small intestine, and composite grafts), all of which include immunoanalysis for the complement split product C4d.Objectives.-To review the general concepts of C4d biology and immunoanalysis, followed by organ-allograftspecific data, and interpretative nuances for kidney, pancreas, and heart, with discussion of early literature for lung and liver biopsies. Additionally, practical applications and limitations of immunostains for infectious organisms (Polyomavirus, Adenoviridae [adenovirus], and the herpes virus family, including Herpes simplex virus, Cytomegalovirus, Human herpes virus 8, and Epstein-Barr virus) are reviewed in the context of transplant recipients.Data Sources.-Our experience and published primary and review literature.Conclusions.-Immunohistochemistry continues to have an important role in transplant pathology, most notably C4d staining in assessment of antibody-mediated rejection and assessment of viral pathogens in tissue. In all facets of transplant pathology, correlation of morphology with special studies and clinical data is critical, as is close communication with the transplant team.

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Pancreas Graft Pathology

Drachenberg,

Papadimitriou

2023

Transplantation of the Pancreas

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Specific humoral rejection of a pancreas allograft in a recipient of pancreas after kidney transplantation

Cited by 21 publications

References 8 publications

Antibody-Mediated Rejection of the Kidney after Simultaneous Pancreas-Kidney Transplantation

Antibody-Mediated Rejection of the Kidney after Simultaneous Pancreas-Kidney Transplantation

Practical Applications in Immunohistochemistry: Evaluation of Rejection and Infection in Organ Transplantation

Pancreas Graft Pathology

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