title: Acute humoral rejection in hepatitis C-infected renal transplant recipients receiving antiviral therapy.
abstract: The use of interferon-alpha (IFN) in hepatitis C (HCV)-infected renal recipients has been associated with acute rejection and graft loss. We reviewed our recent experience in HCV (+) renal recipients treated with antiviral therapy for biopsy proven chronic hepatitis C. Twelve HCV (+) recipients who recently received antiviral therapy were analyzed. Post-treatment sera were tested for donor-specific human leukocyte antigen (HLA) antibodies (DSA). Within 6 months of initiating antiviral therapy, two of 12 patients (17%) developed acute rejection, which was characterized as acute humoral rejection (de novo DSA in serum and C4d deposits in peritubular capillaries). Both progressed to graft failure. Nine of the remaining 10 patients tested did not have DSA. The use of IFN was associated with severe acute humoral rejection (C4d +, DSA +). The recognition of IFN-associated acute humoral rejection in this series may explain the high rate of graft loss reported previously in renal recipients receiving IFN.
authors.affiliation: Department of Medicine, Massachusetts General Hospital and Harvard Medical School, Boston, MA 02114, USA.
authors.forename: Seema
authors.initials: S
authors.lastname: Baid
authors.forename: Nina
authors.initials: N
authors.lastname: Tolkoff-Rubin
authors.forename: Susan
authors.initials: S
authors.lastname: Saidman
authors.forename: Raymond
authors.initials: R
authors.lastname: Chung
authors.forename: Winfred W
authors.initials: WW
authors.lastname: Williams
authors.forename: Hugh
authors.initials: H
authors.lastname: Auchincloss
authors.forename: Robert B
authors.initials: RB
authors.lastname: Colvin
authors.forename: Francis L
authors.initials: FL
authors.lastname: Delmonico
authors.forename: A Benedict
authors.initials: AB
authors.lastname: Cosimi
authors.forename: Manuel
authors.initials: M
authors.lastname: Pascual
mesh_terms: D000328:Adult; D000998:Antiviral Agents / Q000494:pharmacology*; D005260:Female; D006084:Graft Rejection / Q000276:immunology*; D006526:Hepatitis C / Q000276:immunology*; D006801:Humans; D016898:Interferon-alpha / Q000494:pharmacology; D016030:Kidney Transplantation / Q000276:immunology*; D008297:Male; D008875:Middle Aged; D012254:Ribavirin / Q000494:pharmacology
chemical_list: D000998:Antiviral Agents; D016898:Interferon-alpha; D012254:Ribavirin