Biopsy findings on a stable recipient after secondary donor specific antibody (DSA) positive and ABO incompatible kidney transplantation

Using desensitization protocol, we performed a secondary donor specific antibody (DSA) positive and ABO incompatible kidney transplantation. One‐hour biopsy showed no C4d deposition. The protocol biopsy after 2 weeks showed diffuse C4d deposition with peritubulitis. After 12 weeks, however, the prot...

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Bibliographic Details
Published in:Nephrology (Carlton, Vic.) Vic.), 2015-07, Vol.20 (S2), p.79-80
Main Authors: Sugitani, Atsushi, Takahashi, Chihiro, Naka, Takuji, Hisamitsu, Kazunori, Yamamoto, Osamu, Kobayashi, Naoto, Kimura, Mari, Yoshida, Haruhiko, Hanaki, Takehiko, Hamazoe, Ryuichi
Format: Article
Language:English
Subjects:
ABO Blood-Group System - immunology
ABO incompatible transplantation
Allografts
Biopsy
Blood Group Incompatibility - immunology
Blood Group Incompatibility - therapy
Complement C4b - analysis
Desensitization, Immunologic - methods
Histocompatibility
Humans
Immunosuppressive Agents - therapeutic use
Isoantibodies - blood
Kidney - immunology
Kidney - pathology
kidney transplantation
Kidney Transplantation - adverse effects
Male
Middle Aged
Peptide Fragments - analysis
positive crossmatch
protocol biopsy
Reoperation
Time Factors
Treatment Outcome
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Summary:Using desensitization protocol, we performed a secondary donor specific antibody (DSA) positive and ABO incompatible kidney transplantation. One‐hour biopsy showed no C4d deposition. The protocol biopsy after 2 weeks showed diffuse C4d deposition with peritubulitis. After 12 weeks, however, the protocol biopsy showed disappearance of tubulitis in spite of remaining C4d deposition. The recipient was in stable condition with excellent graft function despite high titer of the DSA. Monitoring of protocol biopsy is critical while antibody titer and the interpretation of the histological findings correlating with clinical markers must be considered.
ISSN:1320-5358
1440-1797
DOI:10.1111/nep.12452