Glomerular C4d Immunoperoxidase in Chronic Antibody-Mediated Rejection and Transplant Glomerulopathy
Brian J. Nankivell, Chow Heok P’ng, Meena Shingde
Abstract
Introduction: ) reflected endothelial interaction with antibody and could improve immunologic classification of transplant glomerulopathy (TG). Methods: We evaluated C4d using immunoperoxidase in 3524 consecutive, kidney transplant biopsies from a single center. Results: < 0.001), independent of the severity of glomerulopathy and chronic interstitial fibrosis. Conclusion: is a promising diagnostic biomarker of endothelial interaction with antibody which substantially improved test performance of the Banff schema to correctly classify TG by pathophysiology and prognosticate graft loss. We recommend routine C4d immunoperoxidase to minimize underdiagnosis of late AMR in TG.
Topics & Concepts
MedicinePeritubular capillariesGlomerulopathyProteinuriaPathologyImmunoperoxidaseAntibodyGastroenterologyBiopsyInternal medicineFibrosisKidneyUrologyImmunologyMonoclonal antibodyRenal Transplantation Outcomes and TreatmentsRenal Diseases and GlomerulopathiesVasculitis and related conditions