Publication
Peritubular Capillaries C4d Deposits in Renal Allograft Biopsies and Anti HLA I/II Alloantibodies Screening. Incidence and Clinical Importance
| dc.contributor.author | Viana, H | |
| dc.contributor.author | Carvalho, F | |
| dc.contributor.author | Santos, MC | |
| dc.contributor.author | Galvão, MJ | |
| dc.contributor.author | Santos, AR | |
| dc.contributor.author | Nolasco, F | |
| dc.contributor.author | Ribeiro Santos, J | |
| dc.date.accessioned | 2013-02-20T12:23:52Z | |
| dc.date.available | 2013-02-20T12:23:52Z | |
| dc.date.issued | 2008 | |
| dc.description.abstract | Aim: To characterise clinically the patients with C4d in peritubular capillaries deposits (C4dPTCD) and/or circulating anti-HLA class I/II alloantibodies. To determine the correlation between positive C4dPTCD and circulating anti-HLA class I/II alloantibodies during episodes of graft dysfunction. Subjects and Methods: C4d staining was performed in biopsies with available frozen tissue obtained between January 2004 and December 2006. The study was prospective from March 2005, when a serum sample was obtained at the time of biopsy to detect circulating anti-HLA class I/II alloantibodies. Results: We studied 109 biopsies in 86 cadaver renal transplant patients. Sixteen of these (14.7%) presented diffuse positive C4dPTCD. There was a 13.5% rate of +C4dPTCD incidence within the first six months of transplantation and 16% after six months (p>0.05). Half of the +C4dPTCD in the first six months was associated with acute humoral rejection. After six months, the majority of +C4dPTCD (n=7/8) was present in biopsies with evidence of interstitial fibrosis/tubular atrophy and/or transplant glomerulopathy. The C4dPTCD was more frequent in patients with positive anti-HCV antibodies(p<0.0001), a previous renal transplant (p=0.007), and with a panel reactivity antibody (PRA) ≥ 50%(p=0.0098). The anti-HCV+ patients had longer time on dialysis (p=0.0019) and higher PRA(p=0.005). Circulating anti-HLA I/II alloantibodies were screened in 46 serum samples. They were positive in 10.9% of samples, all obtained after six months post transplant. Circulating alloantibodies were absent in 92.5% of the C4d negative biopsies. Conclusion: We found an association between the presence of C4dPTCD and 2nd transplant recipients,higher PRA and the presence of anti-HCV antibodies. The presence of HCV antibodies is not a risk factor for C4dPTCD per se, but appears to reflect longer time on dialysis and presensitisation. In renal dysfunction a negative alloantibody screening is associated with a reduced risk of C4dPTCD (<10%). | por |
| dc.identifier.citation | Port J Nephrol Hypert 2008; 22 (1): 37-42 | por |
| dc.identifier.uri | http://hdl.handle.net/10400.17/1107 | |
| dc.language.iso | eng | por |
| dc.peerreviewed | yes | por |
| dc.publisher | Sociedade Portuguesa de Nefrologia e Hipertensão | por |
| dc.subject | Hepatite C | por |
| dc.subject | Transplantação de Rim | por |
| dc.subject | Isoanticorpos | por |
| dc.subject | Estudos Prospectivos | por |
| dc.title | Peritubular Capillaries C4d Deposits in Renal Allograft Biopsies and Anti HLA I/II Alloantibodies Screening. Incidence and Clinical Importance | por |
| dc.type | journal article | |
| dspace.entity.type | Publication | |
| oaire.citation.endPage | 42 | por |
| oaire.citation.startPage | 37 | por |
| oaire.citation.title | Revista Portuguesa de Nefrologia e Hipertensão | por |
| rcaap.rights | openAccess | por |
| rcaap.type | article | por |