A case report of a renal transplant recipient developing chronic glomerular rejection with a weak antibody against anti-donor T-cell, only detected by flow-cytometry crossmatch.
The pathogenesis of antibody-mediated rejection has been investigated, but the precise mechanism of chronic glomerular rejection remains unclear. We have followed the clinicopathological course of a patient with pre-existing anti-donor antibody only detected by flow-cytometry crossmatch for over 3 years. Glomerular endothelial injuries and peculiar glomerular lesions were noted in biopsy specimen of postoperative year 3; however, both typical chronic vascular rejection lesions and peritubular capillary multilayered lesions were not revealed. We consider that the presence of weak anti-donor antibody leading early onset of acute humoral rejection played a role in the pathogenesis of early onset of chronic transplant glomerulopathy.
Takeda
Asami
A
Kidney Center, Nagoya Daini Red Cross Hospital, Nagoya City, Japan. asamit@nagoya2.jrc.or.jp
Uchida
Kazuharu
K
Haba
Toshihito
T
Tominaga
Yoshihiro
Y
Katayama
Akio
A
Gotoh
Norihiko
N
Otsuka
Yasuhiro
Y
Fukuda
Michio
M
Horike
Keiji
K
Shimano
Yasunobu
Y
Takeuchi
Oki
O
Yoshida
Atsuhiro
A
Oikawa
Tadashi
T
Morozumi
Kunio
K
D000328:Adult; D001706:Biopsy; D002908:Chronic Disease; D002985:Clinical Protocols; D005260:Female; D005434:Flow Cytometry / Q000379:methods; D006084:Graft Rejection / Q000209:etiology / Q000276:immunology*; D006648:Histocompatibility / Q000276:immunology; D006801:Humans; D007166:Immunosuppressive Agents / Q000627:therapeutic use; D007518:Isoantibodies / Q000276:immunology*; D007668:Kidney / Q000473:pathology*; D016030:Kidney Transplantation / Q000009:adverse effects / Q000276:immunology*; D019520:Living Donors; D013601:T-Lymphocytes / Q000276:immunology*; D014181:Transplantation Immunology / Q000276:immunology; D019737:Transplants / Q000009:adverse effects
D007166:Immunosuppressive Agents; D007518:Isoantibodies