Immunohistochemical staining for proliferation antigen as a predictor of chronic graft dysfunction and renal graft loss.
BACKGROUND
Assessment of proliferation rate (PR%) using monoclonal antibody for Ki-67 antigen has recently been found to have prognostic importance in lung and cardiac allografts. We ascertained whether the same might be true for renal allografts.


METHODS
Newly cut sections from 20 archival paraffin blocks of renal allograft biopsy material showing acute cellular rejection and/or acute tubular necrosis (ATN) and absence of other pathology were stained using MIB-1 antibody and were further double-stained with anti-CD3, anti-CD20 or anti-CD68 antibodies. Counts of staining of mononuclear interstitial cells were correlated with clinical and pathological data.


RESULTS
Mean PR% was significantly greater than that in control renal allografts (13.23 +/- 1.94 vs. 2.84 +/- 1.66, p < 0.01). PR% of cases with ATN and no or borderline rejection was significantly lower than that of the remaining cases with acute rejection pathology (6.68 +/- 1.15 vs. 14.31 +/- 1.62, p < 0.05). However, PR% was neither correlated to histological rejection grade nor to long-term graft outcome. Double labelling failed to identify the cell type of most infiltrating MIB-1 positive cells.


CONCLUSIONS
Positive MIB-1 staining helps to identify the presence of rejection but does not appear to predict prognosis or correlate with the Banff classification of rejection pathology.
Pizov
Galina
G
Department of Pathology, Hadassah Hebrew University Hospital, Jerusalem, Israel.
Friedlaender
Michael M
MM
D000911:Antibodies, Monoclonal; D002455:Cell Division; D006084:Graft Rejection / Q000473:pathology*; D006085:Graft Survival; D006801:Humans; D007150:Immunohistochemistry; D019394:Ki-67 Antigen / Q000032:analysis* / Q000276:immunology; D016030:Kidney Transplantation; D011237:Predictive Value of Tests; D011379:Prognosis; D014184:Transplantation, Homologous
D000911:Antibodies, Monoclonal; D019394:Ki-67 Antigen