Intragraft Donor-Specific Antibodies Correlate with Histological Variability
Overview
This study investigates the relationship between intragraft donor-specific antibodies (gDSA) and histological findings in kidney transplant recipients with concurrent serum donor-specific antibodies (sDSA).
Background
The presence of donor-specific antibodies (DSA) is a critical factor in the pathogenesis of antibody-mediated rejection (ABMR) in kidney transplantation. Understanding the relationship between circulating sDSA and intragraft gDSA can provide insights into the immunologic context of histological variability in kidney allografts.
Data Highlights
Histologic Diagnosis
gDSA Positivity Rate
C4d-only lesions
100.0%
aABMR
90.9%
aABMR+TCMR
83.3%
caABMR
44.4%
No rejection
22.7%
aTCMR
14.3%
Key Findings
The prevalence of gDSA varied significantly across different histologic diagnoses (P = 3.3 × 10-4).
gDSA positivity was highest in C4d-only lesions (100.0%) and aABMR (90.9%).
The gDSA positive rate in aABMR was significantly higher than in the no-rejection group (P = 0.003; OR 34, 95% CI 3.5–334).
The MFI sum of gDSA was significantly higher in aABMR, aABMR+TCMR, and C4d-only lesions (P = 0.009, 0.035, and 0.007, respectively).
No significant difference was observed in the sum of sDSA MFI across histologic groups.
Clinical Implications
The findings indicate that assessing gDSA in kidney biopsies may provide information regarding the immunologic status of the graft in cases of aABMR.
Conclusion
Intragraft gDSA levels correlate with specific histological findings in kidney transplant recipients.
by Hyunjae Lee, Eun Youn Roh, Tae-Shin Kim, Yu Jung Choi, Inseong Oh, Hajeong Lee, Sang Il Min, Chang Wook Jeong, Hee Gyung Kang, Jongwon Ha, Kyung Chul Moon, Eun Young Song
