Chinese Journal of Tissue Engineering Research ›› 2012, Vol. 16 ›› Issue (18): 3249-3254.doi: 10.3969/j.issn.1673-8225.2012.18.005

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Acute humoral rejection after renal transplantation Five-year follow-up of 296 cases from one organization*★

Chen Hua1, Hu Li-juan2, Li Liu-yang1, Chen Jian-rong1, Qian Jun1, Li Min1, Zhao Ming1   

  1. 1Department of Organ Transplantation,    2Department of Oncology, Zhujiang Hospital, Southern Medical University, Guangzhou  510282, Guangdong Province, China
  • Received:2012-01-04 Revised:2012-01-17 Online:2012-04-29 Published:2012-04-29
  • Contact: Li Liu-yang, Technician-in-chief, Department of Organ Transplantation, Zhujiang Hospital, Southern Medical University, Guangzhou 510282, Guangdong Province, China liliuyang@medmail.com.cn
  • About author:Chen Hua★, Master, Attending physician, Department of Organ Transplantation, Zhujiang Hospital, Southern Medical University, Guangzhou 510282, Guangdong Province, China chenhua511@hotmail.com
  • Supported by:

    Natural Science Foundation of Guangdong Province, No. 06024438*

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Abstract:

BACKGROUND: The incidence of acute humoral rejection following renal transplantation is not high, but it can injure allograft severely and lead to dysfunction, and is considered the leading cause of early loss of the grafts.
OBJECTIVE: To investigate the significance of early diagnosis and prevention of acute humoral rejection after renal transplantation.
METHODS: A total of 296 patients were subjected to regular follow-up following renal transplantation, prior to the surgery,  
26 patients were positive for panel reactive antibodies and 270 were negative. The dynamic changes of panel reactive antibodies and donor specific antibodies in peripheral blood were monitored by enzyme-linked immunosorbent assay. C4d deposition and molecular markers of infiltrating lymphocytes in biopsy tissue were observed by immunohistochemistry. The acute humoral rejection was diagnosed according to Banff 2005 criteria and clinical related indexes.
RESULTS AND CONCLUSION: After transplantation, acute humoral rejection was diagnosed in six cases (23%) out of
26 positive patients and in 19 cases (7%) out of 270 negative patients for panel reactive antibodies. The difference of incidence rates between positive and negative patients was significant (P < 0.01). Donor specific antibodies were detected in peripheral serum of 22 patients (88%) who had developed acute humoral rejection and in 1 patient among the other 271 recipients without acute humoral rejection, with significant difference (P < 0.01). 80% of acute humoral rejection patients and 6.7% of non-acute humoral rejection patients were C4d positive. There were significant differences in the C4d positive rates between acute humoral rejection patients and non-acute humoral rejection patients (P < 0.001). Early monitoring of panel reactive antibodies and donor specific antibodies after transplantation, together with C4d deposition in biopsy tissue, may help to timely diagnose acute humoral rejection, and effectively improve the functions and survival rate of allograft.

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