title: Biopsy findings on a stable recipient after secondary donor specific antibody (DSA) positive and ABO incompatible kidney transplantation.
abstract: Using desensitization protocol, we performed a secondary donor specific antibody (DSA) positive and ABO incompatible kidney transplantation. One-hour biopsy showed no C4d deposition. The protocol biopsy after 2 weeks showed diffuse C4d deposition with peritubulitis. After 12 weeks, however, the protocol biopsy showed disappearance of tubulitis in spite of remaining C4d deposition. The recipient was in stable condition with excellent graft function despite high titer of the DSA. Monitoring of protocol biopsy is critical while antibody titer and the interpretation of the histological findings correlating with clinical markers must be considered.
authors.affiliation: Department of Surgery, Yonago Medical Center, Tottori, Japan.
authors.forename: Atsushi
authors.initials: A
authors.lastname: Sugitani
authors.affiliation: Department of Urology, Yonago Medical Center, Tottori, Japan.
authors.forename: Chihiro
authors.initials: C
authors.lastname: Takahashi
authors.affiliation: Department of Surgery, Yonago Medical Center, Tottori, Japan.
authors.forename: Takuji
authors.initials: T
authors.lastname: Naka
authors.affiliation: Department of Surgery, Yonago Medical Center, Tottori, Japan.
authors.forename: Kazunori
authors.initials: K
authors.lastname: Hisamitsu
authors.affiliation: Department of Surgery, Yonago Medical Center, Tottori, Japan.
authors.forename: Osamu
authors.initials: O
authors.lastname: Yamamoto
authors.affiliation: Department of Urology, Yonago Medical Center, Tottori, Japan.
authors.forename: Naoto
authors.initials: N
authors.lastname: Kobayashi
authors.affiliation: Department of Internal Medicine, Yonago Medical Center, Tottori, Japan.
authors.forename: Mari
authors.initials: M
authors.lastname: Kimura
authors.affiliation: Department of Pathology, Yonago Medical Center, Tottori, Japan.
authors.forename: Haruhiko
authors.initials: H
authors.lastname: Yoshida
authors.affiliation: Department of Surgery, Division of Surgical Oncology, Tottori University, Tottori, Japan.
authors.forename: Takehiko
authors.initials: T
authors.lastname: Hanaki
authors.affiliation: Department of Surgery, Yonago Medical Center, Tottori, Japan.
authors.forename: Ryuichi
authors.initials: R
authors.lastname: Hamazoe
mesh_terms: D000017:ABO Blood-Group System / Q000276:immunology*; D064591:Allografts; D001706:Biopsy; D001787:Blood Group Incompatibility / Q000276:immunology* / Q000628:therapy; D015935:Complement C4b / Q000032:analysis; D003888:Desensitization, Immunologic / Q000379:methods; D006648:Histocompatibility; D006801:Humans; D007166:Immunosuppressive Agents / Q000627:therapeutic use; D007518:Isoantibodies / Q000097:blood*; D007668:Kidney / Q000276:immunology* / Q000473:pathology; D016030:Kidney Transplantation / Q000009:adverse effects*; D008297:Male; D008875:Middle Aged; D010446:Peptide Fragments / Q000032:analysis; D012086:Reoperation; D013997:Time Factors; D016896:Treatment Outcome
chemical_list: D000017:ABO Blood-Group System; D007166:Immunosuppressive Agents; D007518:Isoantibodies; D010446:Peptide Fragments; D015935:Complement C4b; C032261:complement C4d
keywords: ABO incompatible transplantation; kidney transplantation; positive crossmatch; protocol biopsy