title: CD20-positive infiltrates in renal allograft biopsies with acute cellular rejection are not associated with worse graft survival.
abstract: We examined rejection outcome and graft survival in 58 adult patients with acute cellular rejection Banff type I (ARI) or II (ARII), within 1 year after transplantation, with or without CD20-positive infiltrates. Antibody-mediated rejection was not examined. Of the 74 allograft biopsies, performed from 1999 to 2001, 40 biopsies showed ARI and 34 biopsies showed ARII; 30% of all the biopsies showed CD20-positive clusters with more than 100 cells, 9% with more than 200 cells and 5% with more than 275 cells. Patients with B cell-rich (>100 or >200/HPF CD20-positive cells) and B cell-poor biopsies (<50 CD20-positive cells/HPF) were compared. Serum creatinine and eGFR of B cell-rich (CD20 > 100/HPF) and B cell-poor were not significantly different at rejection, or at 1, 3, 6 and 12 months, and during additional 3 years follow-up after rejection, although higher creatinine at 1 year was noted in the >200/HPF group. Graft survival was also not different between B cell-rich and B cell-poor groups (p = 0.8 for >100/HPF, p = 0.9 for >200/HPF CD20-positive cells). Our data do not support association of B cell-rich infiltrates in allograft biopsies and worse outcome in acute rejection type I or II, but do not exclude the possible contribution of B cells to allograft rejection.
authors.affiliation: Department of Pathology, Johns Hopkins University, Baltimore, MD, USA. sbagnas1@jhmi.edu
authors.forename: S M
authors.initials: SM
authors.lastname: Bagnasco
authors.forename: W
authors.initials: W
authors.lastname: Tsai
authors.forename: M H
authors.initials: MH
authors.lastname: Rahman
authors.forename: E S
authors.initials: ES
authors.lastname: Kraus
authors.forename: L
authors.initials: L
authors.lastname: Barisoni
authors.forename: R
authors.initials: R
authors.lastname: Vega
authors.forename: L C
authors.initials: LC
authors.lastname: Racusen
authors.forename: M
authors.initials: M
authors.lastname: Haas
authors.forename: B S
authors.initials: BS
authors.lastname: Mohammed
authors.forename: A A
authors.initials: AA
authors.lastname: Zachary
authors.forename: R A
authors.initials: RA
authors.lastname: Montgomery
mesh_terms: D000208:Acute Disease; D000328:Adult; D000368:Aged; D018951:Antigens, CD20 / Q000276:immunology*; D001402:B-Lymphocytes / Q000276:immunology / Q000473:pathology; D003404:Creatinine / Q000097:blood; D004797:Enzyme-Linked Immunosorbent Assay; D005260:Female; D005500:Follow-Up Studies; D005919:Glomerular Filtration Rate; D006084:Graft Rejection / Q000097:blood / Q000276:immunology / Q000473:pathology*; D006085:Graft Survival / Q000276:immunology*; D006801:Humans; D016030:Kidney Transplantation / Q000276:immunology*; D008297:Male; D008875:Middle Aged; D011379:Prognosis; D012189:Retrospective Studies; D012720:Severity of Illness Index; D013997:Time Factors
chemical_list: D018951:Antigens, CD20; D003404:Creatinine