title: Three-year outcome of isolated glomerulitis on 3-month protocol biopsies of donor HLA antibody negative patients.
abstract: Transplant glomerulitis (TG) can lead to the diagnosis of acute humoral rejection when associated with C4d. Recent data have shown that, in patients with donor-specific antibodies, TG is a sign of humoral rejection, even in the absence of C4d. However, the clinical significance of isolated TG, i.e. TG without C4d deposition or morphological evidence of rejection, has not been specifically studied in protocol biopsies of recipients without donor-specific antibodies. We compared 20 isolated TG-patients with 44 selected recipients without TG or any rejection-associated change. The two groups had similar baseline characteristics. After a 3 year follow-up, renal function, acute rejection rate, and development of HLA antibodies were not significantly different between the two groups. Isolated TG had no deleterious consequences on the 3 year graft outcome. Eleven patients of the glomerulitis-group had another allograft biopsy during follow-up: glomerular lesions returned to normal in six patients whereas the persistence of glomerulitis or features consistent with chronic transplant glomerulopathy were noticed in the remaining five patients. Four of these five patients had pretransplant non-donor specific HLA antibodies. In conclusion, although isolated TG had no impact on allograft function at 3 year, histological outcome could be related to patient sensitization.
authors.affiliation: Institut de Pathologie, Centre de Biologie-Pathologie, CHU de Lille, F-59000 Lille, France. buob.david@gmail.com
authors.forename: David
authors.initials: D
authors.lastname: Buob
authors.forename: Philippe
authors.initials: P
authors.lastname: Grimbert
authors.forename: François
authors.initials: F
authors.lastname: Glowacki
authors.forename: Myriam
authors.initials: M
authors.lastname: Labalette
authors.forename: Françoise
authors.initials: F
authors.lastname: Dufossé
authors.forename: Dominique
authors.initials: D
authors.lastname: Nochy
authors.forename: Marie-Christine
authors.initials: MC
authors.lastname: Copin
authors.forename: Emmanuel
authors.initials: E
authors.lastname: Boleslawski
authors.forename: Christian
authors.initials: C
authors.lastname: Noël
authors.forename: Marc
authors.initials: M
authors.lastname: Hazzan
mesh_terms: D000328:Adult; D015415:Biomarkers / Q000097:blood; D001707:Biopsy, Needle; D016022:Case-Control Studies; D005260:Female; D005500:Follow-Up Studies; D005921:Glomerulonephritis / Q000209:etiology / Q000473:pathology*; D006084:Graft Rejection / Q000276:immunology / Q000473:pathology*; D006680:HLA Antigens / Q000276:immunology; D006801:Humans; D007518:Isoantibodies / Q000097:blood / Q000276:immunology; D007668:Kidney / Q000473:pathology; D016030:Kidney Transplantation / Q000276:immunology*; D008297:Male; D008875:Middle Aged; D011183:Postoperative Complications / Q000473:pathology*; D011379:Prognosis; D012189:Retrospective Studies; D016896:Treatment Outcome
chemical_list: D015415:Biomarkers; D006680:HLA Antigens; D007518:Isoantibodies