Clinical impacts of CD38+ B cells on acute cellular rejection with CD20+ B cells in renal allograft.
BACKGROUND
There is an increasing evidence that the presence of CD20 B cells is associated with poor clinical outcomes in acute cellular rejection (ACR), but clinical significance of CD38 B cells is undetermined. We attempted to examine the clinical significance of the CD38 B cells alone or in combination with CD20 B cells in renal transplant recipients with ACR.


METHODS
Fifty-four patients with ACR were included. Biopsy specimens were stained for CD20 and CD38. The clinical outcomes of CD20 or CD38 B cells were evaluated with late-onset and repeated ACR, steroid resistance, incomplete recovery after rejection treatment, and allograft survival.


RESULTS
Twenty-three patients (42.6%) had CD20 and 25 (46.3%) patients had CD38 B cells. Of these, 15 patients (27.8%) were positive for both CD20 and CD38 (CD20CD38). CD38 patients had higher rates of late-onset or repeated ACR and incomplete recovery compared with CD38 patients (P<0.05). The patients with CD20CD38 had a higher incomplete recovery rate than did patients with only CD20 or CD38 (P<0.05). The 5-year allograft survival was lower in CD20 and CD38 patients than in CD20 or CD38 patients (P<0.05 for each). CD20CD38 patients had lower graft survival than did patients with CD20 or CD38 alone (P<0.05).


CONCLUSIONS
Infiltration of CD38 B cells alone or in combination with CD20 B cells is a predictor for poor clinical outcomes of ACR in renal allograft.
Hwang
Hyeon Seok
HS
Transplantation Research Center, Seoul St. Mary's Hospital, Seoul, Korea.
Song
Ji Hyun
JH
Hyoung
Bok Jin
BJ
Lee
So Young
SY
Jeon
Youn Joo
YJ
Kang
Seok Hui
SH
Chung
Byung Ha
BH
Choi
Bum Soon
BS
Choi
Yeong Jin
YJ
Kim
Ji Il
JI
Moon
In Sung
IS
Kim
Yong Soo
YS
Yang
Chul Woo
CW
D051997:ADP-ribosyl Cyclase 1 / Q000096:biosynthesis*; D000328:Adult; D017668:Age of Onset; D018951:Antigens, CD20 / Q000096:biosynthesis*; D001402:B-Lymphocytes / Q000276:immunology* / Q000378:metabolism; D001706:Biopsy; D005260:Female; D006084:Graft Rejection; D006085:Graft Survival; D006801:Humans; D007166:Immunosuppressive Agents / Q000627:therapeutic use; D016030:Kidney Transplantation / Q000379:methods*; D008297:Male; D008875:Middle Aged; D051437:Renal Insufficiency / Q000097:blood* / Q000628:therapy*; D016896:Treatment Outcome
D018951:Antigens, CD20; D007166:Immunosuppressive Agents; D051997:ADP-ribosyl Cyclase 1