title: The Effect of Histological CD20-Positive B Cell Infiltration in Acute Cellular Rejection on Kidney Transplant Allograft Survival.
abstract: Background. It is controversial whether lymphocyte infiltration exhibited in biopsy specimens is associated with transplant outcomes. This study focused on the effect of CD20-positive B cell infiltration in biopsy specimens from allografts with acute cellular rejection (ACR) in a Chinese population.Methods. Altogether, 216 patients transplanted from Sep. 2001 to Dec. 2014 with biopsy-proved ACR (Banff I or Banff II) were included in the analysis. Biopsies were immunostained for CD20 and C4d. Baseline information, serum creatinine and GFR before and after treatment, steroid resistance, response to treatment, graft loss, and survival were analyzed.Results. Eighty-three patients were classified into CD20-negative group, and 133 patients were classified into CD20-positive group. Significantly more CD20-negative patients (49/83, 59.0%) received steroid plus antibody therapy compared with the CD20-positive group (52/133, 39.1%) (P= 0.004). The response to treatment for ACR did not differ between these two groups. The CD20-positive group had less graft loss (18.8% versus 32.5%,P= 0.022) and a better graft survival rate. Further exploration of the infiltration degree suggested that it tended to be positively related to graft survival, but this did not reach statistical significance.Conclusion. CD20-positive B cell infiltration in renal allograft biopsies with ACR is associated with less steroid resistance and better graft survival. The presence of CD20-positive B cells is protective for renal allografts.
authors.affiliation: Kidney Disease Center, The First Affiliated Hospital, College of Medicine, Zhejiang University, Hangzhou, China; Key Laboratory of Kidney Disease Prevention and Control Technology, Zhejiang Province, China; The Third Grade Laboratory under the National State, Administration of Traditional Chinese Medicine, Hangzhou 310003, China.
authors.forename: Yan
authors.initials: Y
authors.lastname: Jiang
authors.affiliation: Kidney Disease Center, The First Affiliated Hospital, College of Medicine, Zhejiang University, Hangzhou, China; Key Laboratory of Kidney Disease Prevention and Control Technology, Zhejiang Province, China; The Third Grade Laboratory under the National State, Administration of Traditional Chinese Medicine, Hangzhou 310003, China.
authors.forename: Rending
authors.initials: R
authors.lastname: Wang
authors.affiliation: Kidney Disease Center, The First Affiliated Hospital, College of Medicine, Zhejiang University, Hangzhou, China; Key Laboratory of Kidney Disease Prevention and Control Technology, Zhejiang Province, China; The Third Grade Laboratory under the National State, Administration of Traditional Chinese Medicine, Hangzhou 310003, China.
authors.forename: Huiping
authors.initials: H
authors.lastname: Wang
authors.affiliation: Kidney Disease Center, The First Affiliated Hospital, College of Medicine, Zhejiang University, Hangzhou, China; Key Laboratory of Kidney Disease Prevention and Control Technology, Zhejiang Province, China; The Third Grade Laboratory under the National State, Administration of Traditional Chinese Medicine, Hangzhou 310003, China.
authors.forename: Hongfeng
authors.initials: H
authors.lastname: Huang
authors.affiliation: Kidney Disease Center, The First Affiliated Hospital, College of Medicine, Zhejiang University, Hangzhou, China; Key Laboratory of Kidney Disease Prevention and Control Technology, Zhejiang Province, China; The Third Grade Laboratory under the National State, Administration of Traditional Chinese Medicine, Hangzhou 310003, China.
authors.forename: Wenhan
authors.initials: W
authors.lastname: Peng
authors.affiliation: Kidney Disease Center, The First Affiliated Hospital, College of Medicine, Zhejiang University, Hangzhou, China; Key Laboratory of Kidney Disease Prevention and Control Technology, Zhejiang Province, China; The Third Grade Laboratory under the National State, Administration of Traditional Chinese Medicine, Hangzhou 310003, China.
authors.forename: Wenxian
authors.initials: W
authors.lastname: Qiu
authors.affiliation: Kidney Disease Center, The First Affiliated Hospital, College of Medicine, Zhejiang University, Hangzhou, China; Key Laboratory of Kidney Disease Prevention and Control Technology, Zhejiang Province, China; The Third Grade Laboratory under the National State, Administration of Traditional Chinese Medicine, Hangzhou 310003, China.
authors.forename: Jingyi
authors.initials: J
authors.lastname: Zhou
authors.affiliation: Kidney Disease Center, The First Affiliated Hospital, College of Medicine, Zhejiang University, Hangzhou, China; Key Laboratory of Kidney Disease Prevention and Control Technology, Zhejiang Province, China; The Third Grade Laboratory under the National State, Administration of Traditional Chinese Medicine, Hangzhou 310003, China.
authors.forename: Jianghua
authors.identifier: 0000-0002-3282-3998
authors.initials: J
authors.lastname: Chen
mesh_terms: D000328:Adult; D064591:Allografts; D018951:Antigens, CD20 / Q000276:immunology*; D001402:B-Lymphocytes / Q000276:immunology*; D001706:Biopsy; D015704:CD4 Antigens / Q000276:immunology; D003404:Creatinine / Q000097:blood; D005260:Female; D006084:Graft Rejection / Q000276:immunology*; D006085:Graft Survival / Q000276:immunology*; D006801:Humans; D007668:Kidney / Q000473:pathology / Q000601:surgery; D016030:Kidney Transplantation; D008297:Male; D012189:Retrospective Studies; D014184:Transplantation, Homologous; D016896:Treatment Outcome
chemical_list: D018951:Antigens, CD20; D015704:CD4 Antigens; D003404:Creatinine