Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
. 2012 Mar 27;8(5):255-7.
doi: 10.1038/nrneph.2012.61.

Diagnostic challenges in chronic antibody-mediated rejection

Evan A Farkash  1 , Robert B Colvin
Affiliations

Diagnostic challenges in chronic antibody-mediated rejection

Evan A Farkash et al. Nat Rev Nephrol. .

Abstract

Measurement of glomerular and peritubular capillaritis in kidney transplant biopsy samples identifies allograft dysfunction associated with alloantibodies. Sis et al. show that this technique has a higher sensitivity but lower specificity than the current diagnostic criteria using peritubular capillary C4d deposition, and that capillaritis is an independent predictor of progression to graft failure.

PubMed Disclaimer

Conflict of interest statement

Competing interests

The authors declare no competing interests.

Figures

Figure 1
Figure 1
Mechanisms of donor-specific antibody-mediated endothelial injury in renal allografts. Anti-MHC antibodies can cause direct injury to the capillary endothelium, or indirect injury via complement fixation or recruitment of inflammatory cells with Fc receptors. Endothelial injury and cellular recruitment could be important mediators in cases with donor-specific antibodies that lack C4d deposition. Capillaritis has been proposed as a sensitive marker for the presence of donor-specific antibodies and late allograft rejection. Abbreviations: MHC, major histocompatibility complex; NK, natural killer cell; Poly, polymorphonuclear cell.
See this image and copyright information in PMC

References

    1. Gaston RS, et al. Evidence for antibody-mediated injury as a major determinant of late kidney allograft failure. Transplantation. 2010;90:68–74. - PubMed
    1. Solez K, et al. Banff ‘05 Meeting Report: differential diagnosis of chronic allograft injury and elimination of chronic allograft nephropathy (‘CAN’) Am J Transplant. 2007;7:518–526. - PubMed
    1. Regele H, et al. Capillary deposition of complement split product C4d in renal allografts is associated with basement membrane injury in peritubular and glomerular capillaries: a contribution of humoral immunity to chronic allograft rejection. J Am Soc Nephrol. 2002;13:2371–2380. - PubMed
    1. Gibson IW, et al. Peritubular capillaritis in renal allografts: prevalence, scoring system, reproducibility and clinicopathological correlates. Am J Transplant. 2008;8:819–825. - PubMed
    1. Loupy A, et al. Significance of C4d Banff scores in early protocol biopsies of kidney transplant recipients with preformed donor-specific antibodies (DSA) Am J Transplant. 2011;11:56–65. - PubMed

MeSH terms