title: Acute cellular rejection predominated by monocytes is a severe form of rejection in human renal recipients with or without Campath-1H (alemtuzumab) induction therapy.
abstract: Campath-1H has been used successfully for induction and has resulted in a low rate of acute cellular rejection (ACR) in renal transplantation in combination with various postoperative immunosuppression regimens. This study was undertaken to investigate the extent of monocyte involvement in ACR, with or without Campath-1H induction. We found that monocytes represented the majority of inflammatory cells in grades Ib or higher ACR, but not with Ia type of ACR, regardless of the status of Campath-1H induction. Cases of ACR, following Campath-1H induction, appear to demonstrate a 'pure form' of monocytic ACR, whereas monocytes were mixed with many other types of inflammatory cells in the cases of ACR in the absence of Campath-1H induction. In addition with Campath-1H induction, the cases of monocyte-predominant ACR were found to uniformly exhibit a good response to corticosteroid treatment. We conclude that monocyte-predominate ACR may represent a severe form of rejection, with or without Campath-1H treatment.
authors.affiliation: Division of Laboratory Medicine, Geisinger Medical Center, Danville, PA, USA. plzhang@geisinger.edu
authors.forename: Ping L
authors.initials: PL
authors.lastname: Zhang
authors.forename: Sayeed K
authors.initials: SK
authors.lastname: Malek
authors.forename: Jeffery W
authors.initials: JW
authors.lastname: Prichard
authors.forename: Fan
authors.initials: F
authors.lastname: Lin
authors.forename: Taher M
authors.initials: TM
authors.lastname: Yahya
authors.forename: Michael S
authors.initials: MS
authors.lastname: Schwartzman
authors.forename: Ruth P
authors.initials: RP
authors.lastname: Latsha
authors.forename: Evan R
authors.initials: ER
authors.lastname: Norfolk
authors.forename: Thomas M
authors.initials: TM
authors.lastname: Blasick
authors.forename: Mingyue
authors.initials: M
authors.lastname: Lun
authors.forename: Robert E
authors.initials: RE
authors.lastname: Brown
authors.forename: James E
authors.initials: JE
authors.lastname: Hartle
authors.forename: Santosh
authors.initials: S
authors.lastname: Potdar
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000074323:Alemtuzumab; D000911:Antibodies, Monoclonal / Q000276:immunology / Q000494:pharmacology*; D061067:Antibodies, Monoclonal, Humanized; D000912:Antibodies, Neoplasm / Q000276:immunology / Q000494:pharmacology*; D015703:Antigens, CD / Q000276:immunology; D000951:Antigens, Neoplasm / Q000276:immunology; D000074301:CD52 Antigen; D005260:Female; D006023:Glycoproteins / Q000276:immunology; D006084:Graft Rejection / Q000517:prevention & control*; D006801:Humans; D007668:Kidney / Q000187:drug effects / Q000473:pathology; D016030:Kidney Transplantation; D008297:Male; D008875:Middle Aged; D009000:Monocytes / Q000187:drug effects*
chemical_list: D000911:Antibodies, Monoclonal; D061067:Antibodies, Monoclonal, Humanized; D000912:Antibodies, Neoplasm; D015703:Antigens, CD; D000951:Antigens, Neoplasm; D000074301:CD52 Antigen; C000613862:CD52 protein, human; D006023:Glycoproteins; D000074323:Alemtuzumab