title: CD20+ B-cell infiltration is related to the time after transplant and poor prognosis of acute cellular rejection in renal transplant.
abstract: OBJECTIVE
  This study sought to determine the relation between CD20+ B-cell infiltration and time after transplant and outcome of acute cellular rejection in renal allografts.
  
  
  METHODS
  Fifty-five patients with acute cellular rejection were categorized into 3 groups: very early, early, and late rejection. The density of CD4+, CD8+, CD20+, and CD68+ cells and HLA-DR expression were characterized and quantified using immunohistochemical staining. Histologic changes were compared between high-density and low-density CD20+ B-cell groups. Poor prognosis factors were analyzed with Cox proportional regression.
  
  
  RESULTS
  Density of CD20+ cells in the very-early rejection group was lower than it was in the early- and late-acute rejection groups (P = .03); the density of CD4+, CD8+, and CD68+ cells and HLA-DR expression did not differ between the groups. Mesangial matrix increase, tubular atrophy, arteriolar hyaline thickening, and tubulitis were more prevalent in the high CD20+ density group. Cox regression analysis demonstrated that HLA-DR expression on the tubules, arteriolar hyaline thickening, and CD20+ cell density were associated with an elevated risk of acute cellular rejection.
  
  
  CONCLUSIONS
  Expansion aggregation of CD20+ B cells occurred mostly after 2 weeks. When combined with HLA-DR expression and arteriolar hyaline thickening, these influence the outcome of acute cellular rejection in renal allograft.
authors: Research Institute of Nephrology, Jinling Hospital, Nanjing University School of Medicine, Nanjing, China.
authors: Wen
authors: W
authors: Jiqiu
authors: Chen
authors: C
authors: Jinsong
authors: Cheng
authors: C
authors: Dongrui
authors: Zhang
authors: Z
authors: Mingchao
authors: Ji
authors: J
authors: Shuming
authors: Liu
authors: L
authors: Zhi-Hong
mesh_terms: D000208:Acute Disease; D000328:Adult; D018951:Antigens, CD20 / Q000378:metabolism*; D001402:B-Lymphocytes / Q000276:immunology* / Q000378:metabolism; D015415:Biomarkers / Q000378:metabolism; D016009:Chi-Square Distribution; D005260:Female; D006084:Graft Rejection / Q000276:immunology* / Q000378:metabolism / Q000401:mortality / Q000473:pathology; D006684:HLA-DR Antigens / Q000378:metabolism; D006801:Humans; D006818:Hyalin / Q000378:metabolism; D007111:Immunity, Cellular; D053208:Kaplan-Meier Estimate; D007668:Kidney / Q000276:immunology* / Q000378:metabolism / Q000473:pathology; D016030:Kidney Transplantation / Q000009:adverse effects* / Q000401:mortality; D016018:Least-Squares Analysis; D008297:Male; D008875:Middle Aged; D015999:Multivariate Analysis; D016016:Proportional Hazards Models; D012189:Retrospective Studies; D012307:Risk Factors; D013997:Time Factors; D016896:Treatment Outcome; D055815:Young Adult
chemical_list: D018951:Antigens, CD20; D015415:Biomarkers; D006684:HLA-DR Antigens