Detection of plasma cells, C4d deposits and donor-specific antibodies on sequential graft biopsies of renal transplant recipients with chronic dysfunction.
BACKGROUND
In order to look for a relationship between humoral mechanisms of rejection and chronic allograft dysfunction, plasma cells, C4d deposits and donor-specific antibodies (DSA) were simultaneously sought on serial biopsies of kidney allograft recipients.


METHODS
Ten recipients with chronic dysfunction (G1) and 8 recipients with long-term normal graft function (G2) were included. Biopsies and serums were sampled at early graft dysfunction (T1), between 8months and 2years (T2) and after the third year following transplantation (T3).


RESULTS
In G1, plasma cells represented 12.3% (T1), 8.2% (T2) and 14.1% (T3) of mononuclear cells. The mean percentage of plasma cells was 11.6% in G1 versus 0.4% in G2 (p<0.05). A progressive rise in C4d deposits was seen in G1, from 25% at T1 to 80% at T3. Donor-specific antibodies were identified in at least one serum sample of 60% of the patients in G1 and 12.5% of the patients in G2 (p=0.012), whereas donor-specific antibodies were eluted from at least one biopsy of 50% of the patients in G1 and 12.5% of the patients in G2 (p=0.03). In G1, C4d deposits were significantly associated with plasma cells (p=0.0012) and anti-HLA Abs in serum samples and/or eluates (p=0.026).


CONCLUSIONS
This study shows that plasma cells, DSA and C4d are associated in renal transplants developing chronic rejection.
Martin
Laurent
L
Department of Pathology, PTB, 2 rue Angélique Ducoudray 21070 Dijon, France. laurent.martin@u-bourgogne.fr
Charon-Barra
Céline
C
Bocrie
Olivier
O
Guignier
Fredy
F
D'Athis
Philippe
P
Dautin
Guillaume
G
de la Vega
Mathilde Funes
MF
Justrabo
Eve
E
Rifle
Gérard
G
Mousson
Christiane
C
D001706:Biopsy; D002452:Cell Count; D002908:Chronic Disease; D015935:Complement C4b / Q000276:immunology / Q000378:metabolism*; D051799:Delayed Graft Function / Q000097:blood / Q000276:immunology*; D005260:Female; D005500:Follow-Up Studies; D006084:Graft Rejection / Q000097:blood / Q000276:immunology*; D006680:HLA Antigens / Q000276:immunology; D006801:Humans; D007105:Immune Complex Diseases / Q000097:blood / Q000276:immunology*; D007518:Isoantibodies / Q000378:metabolism; D007668:Kidney / Q000276:immunology / Q000378:metabolism* / Q000473:pathology; D016030:Kidney Transplantation; D008297:Male; D008875:Middle Aged; D010446:Peptide Fragments / Q000276:immunology / Q000378:metabolism*; D010950:Plasma Cells / Q000473:pathology
D006680:HLA Antigens; D007518:Isoantibodies; D010446:Peptide Fragments; D015935:Complement C4b; C032261:complement C4d