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Donor-specific antibodies,glomerulitis,and human leukocyte antigen B eplet mismatch are risk factors for peritubular capillary C4d deposition in renal allografts

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Chinese Medical Journal 2021年第23期134卷 2874-2881页

作者： Jin Zheng Hui Guo Hui-Lin Gong Ping Lan Chen-Guang Ding Yang Li Xiao-Ming Ding Wu-Jun Xue Department of Kidney Transplantation The First Affiliated Hospital of Xi’an Jiaotong UniversityXi’anShaanxi 710061China Institute of Organ Transplantation Tongji Hospital affiliated to Tongji Medical CollegeHuazhong University of Science and TechnologyWuhanHubei 430030China Department of Pathology The First Affiliated Hospital of Xi’an Jiaotong UniversityXi’anShaanxi 710061China Department of Nephrology The First Affiliated Hospital of Xi’an Jiaotong UniversityXi’anShaanxi 710061China.

Background:The complement system plays an important role in the immune response to transplantation,and the diagnostic significance of peritubular capillary(PTC)C4d deposition(C4d+)in grafts is *** study aimed to fully investigate the risk factors for PTC C4d+and analyze its significance in biopsy pathology of kidney ***:This retrospective study included 124 cases of kidney transplant with graft biopsy and donor-specific antibody(DSA)testing from January 2017 to December 2019 in a single *** effects of recipient pathological indicators,eplet mismatch(MM),and DSAs on PTC C4d+were examined using univariate and multivariate logistic regression ***:In total,35/124(28%)were PTC C4d+,including 21 with antibody-mediated rejection(AMR),eight with renal tubular injury,three with T cell-mediated rejection,one with glomerular disease,and two *** analysis revealed that DSAs(Pglomerulitis(Pglomerulitis(OR:3.581,95%CI:1.246–10.289,P=0.018),and HLA B eplet MM(OR:1.166,95%CI:1.005–1.353,P=0.042)were the independent risk factors for PTC C4d+.In receiver operating characteristic curve analysis,the area under the curve was increased to 0.831 for predicting PTC C4d+when considering glomerulitis,DSAs,and HLA B eplet *** proportions of HLA I DSAs and PTC C4d+in active antibody-mediated rejection were 12/17 and 15/17,respectively;the proportions of HLA class II DSAs and PTC C4d+in chronic AMR were 8/12 and 7/12,***,the higher the PTC C4d+score was,the more serious the urinary occult blood and proteinuria of recipients at the time of ***:PTC C4d+was mainly observed in AMR ***,glomerulitis,and HLA B eplet MM are the independent risk

关键词： Kidney transplantation C4d deposition donor-specific antibody glomerulitis human leukocyte antigen eplet

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