High Specificity of C4d/CD68 Staining for the Diagnosis of Late Antibody-Mediated Rejection in Heart Transplantation.
Détails
ID Serval
serval:BIB_6FB0640A2595
Type
Actes de conférence (partie): contribution originale à la littérature scientifique, publiée à l'occasion de conférences scientifiques, dans un ouvrage de compte-rendu (proceedings), ou dans l'édition spéciale d'un journal reconnu (conference proceedings).
Sous-type
Poster: résume de manière illustrée et sur une page unique les résultats d'un projet de recherche. Les résumés de poster doivent être entrés sous "Abstract" et non "Poster".
Collection
Publications
Institution
Titre
High Specificity of C4d/CD68 Staining for the Diagnosis of Late Antibody-Mediated Rejection in Heart Transplantation.
Titre de la conférence
9th Joint Meeting of the American Society of Transplant Surgeon and of the American Society of Transplantation
Adresse
Boston, Massachusetts, May 30-June 3, 2009
ISBN
1600-6135
Statut éditorial
Publié
Date de publication
2009
Peer-reviewed
Oui
Volume
9
Série
American Journal of Transplantation
Pages
656
Langue
anglais
Notes
Publication type : Meeting Abstract
Résumé
In heart transplantation (HTx), acute antibody-mediated rejection (AMR) is
infrequent but carries high mortality and increased risk of graft vasculopathy.
The diagnosis requires evidence of acute graft dysfunction, capillary lesions on
endomyocardial biopsy (EMB), and immunopathological criteria of antibodymediated
injury. Multiple markers of antibody-mediated injuries have been proposed,
but there is ample debate on their usefulness. In kidney transplantation, C4d
deposition in peritubular capillaries is a reliable marker of alloantibody-dependant
graft injury. In this study, we prospectively screened all EMBs for C4d and CD68
in new HTx recipients, and correlated pathological fi ndings with immunological
evidence of donor-specifi c antibodies (DSA) and graft dysfunction.
Methods
Between Nov 05 and Aug 08, we had 22 HTx, and 17 cases were analysed. All
recipients received polyclonal rabbit anti-thymocytes globulin, calcineurin inhibitors,
mycophenolate mofetil, and corticosteroids (weaning in 6 -12 months). They had
EMB every 1-2 weeks in the fi rst 3 months, and then monthly for 9 months. C4d and
CD 68 were assessed by immunochemistry. Echocardiography and DSA assessment
or crossmatch (early phase) were realised if C4d or CD68 staining was positive.
Results
There was 1 early and 1 late AMR.
Table 1
C4d and CD68 positive, at least 1 EMB 6 / 17; 35% 1 treated
C4d and CD68 positive, at least 2 consecutive EMBs 3 / 17; 17.5% 1 treated
C4d and CD68 positive, and graft dysfunction 1 / 17; 6% 1 treated
C4d and CD68 positive, with DSA and crossmatch + 1 / 17; 6% 1 treated
Table 2
C4d and CD68 positive, at least 1 EMB 1 / 17; 6% 1 treated
C4d and CD68 positive, at least 2 consecutive EMBs 1 /17; 6% 1 treated
C4d and CD68 positive and graft dysfunction 1 / 17; 6% 1 treated
C4d and CD68 positive, and + DSA 1 / 17; 6% 1 treated
Conclusion
In this single-center experience, C4d / CD68 positive staining was frequent in the
early phase and raised the question of false positive cases of AMR. However, these
markers showed high specifi city for the diagnosis of AMR in the late phase. Of
course these data need to be confi rmed in larger multi-center studies.
infrequent but carries high mortality and increased risk of graft vasculopathy.
The diagnosis requires evidence of acute graft dysfunction, capillary lesions on
endomyocardial biopsy (EMB), and immunopathological criteria of antibodymediated
injury. Multiple markers of antibody-mediated injuries have been proposed,
but there is ample debate on their usefulness. In kidney transplantation, C4d
deposition in peritubular capillaries is a reliable marker of alloantibody-dependant
graft injury. In this study, we prospectively screened all EMBs for C4d and CD68
in new HTx recipients, and correlated pathological fi ndings with immunological
evidence of donor-specifi c antibodies (DSA) and graft dysfunction.
Methods
Between Nov 05 and Aug 08, we had 22 HTx, and 17 cases were analysed. All
recipients received polyclonal rabbit anti-thymocytes globulin, calcineurin inhibitors,
mycophenolate mofetil, and corticosteroids (weaning in 6 -12 months). They had
EMB every 1-2 weeks in the fi rst 3 months, and then monthly for 9 months. C4d and
CD 68 were assessed by immunochemistry. Echocardiography and DSA assessment
or crossmatch (early phase) were realised if C4d or CD68 staining was positive.
Results
There was 1 early and 1 late AMR.
Table 1
C4d and CD68 positive, at least 1 EMB 6 / 17; 35% 1 treated
C4d and CD68 positive, at least 2 consecutive EMBs 3 / 17; 17.5% 1 treated
C4d and CD68 positive, and graft dysfunction 1 / 17; 6% 1 treated
C4d and CD68 positive, with DSA and crossmatch + 1 / 17; 6% 1 treated
Table 2
C4d and CD68 positive, at least 1 EMB 1 / 17; 6% 1 treated
C4d and CD68 positive, at least 2 consecutive EMBs 1 /17; 6% 1 treated
C4d and CD68 positive and graft dysfunction 1 / 17; 6% 1 treated
C4d and CD68 positive, and + DSA 1 / 17; 6% 1 treated
Conclusion
In this single-center experience, C4d / CD68 positive staining was frequent in the
early phase and raised the question of false positive cases of AMR. However, these
markers showed high specifi city for the diagnosis of AMR in the late phase. Of
course these data need to be confi rmed in larger multi-center studies.
Mots-clé
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Web of science
Création de la notice
27/07/2010 16:55
Dernière modification de la notice
20/08/2019 15:28
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