Immunofluorescent examination of biopsies from long-term renal allografts

Abstract

Immunofluorescent examination of open renal biopsies revealed clear-cut glomerular localization of immunoglobulins not related clearly to the quality of donor-recipient histocompatibility in 19 of 34 renal allografts. The biopsies were obtained 18 to 31 months after transplantations primarily from related donors with a variable quality of histocompatibility match. IgG was the predominant immunoglobulin class fixed in 13 biopsies, and IgM in six. The pattern of immunoglobulin deposition was linear, connoting anti-GBM antibody in four of the 19; it was granular and discontinuous, connoting antigen-antibody-complex deposits, in 13. An immune process may affect glomeruli of renal allografts by mechanisms comparable to those that cause glomerulonephritis in native kidneys. The transplant glomerulonephritis may represent a persistence of the same disease that originally destroyed the host kidneys or the consequence of a new humoral antibody response to allograft antigens.

FIGURE 1

Photomicrograph of Immunofluorescence of Typical Linear Fixation of IgG on Glomerular Walls of Case 2.

FIGURE 2

Photomicrograph of Immunofluorescence of Typical Discontinuous, Granular Deposits of IgG Found on Glomerular Capillaries in the Biopsy of Case 5.

FIGURE 3

Photomicrograph of Immunofluorescence of Focal Deposits of IgG as I'isualized in Glomeruli of Case 9 (the Same Biopsy Was Stained for Presence of IgM and Showed a Typical Diffuse Granular Pattern).