Plasma cell densities and glomerular filtration rates predict renal allograft outcomes following acute rejection

Anthony Chang, Jocelyn M. Moore, Michelle L. Cowan, Michelle A. Josephson, W. James Chon, Roger Sciammas, Zeying Du, Susana R. Marino, Shane M. Meehan, Michael Millis, Michael Z. David, James W. Williams, Anita S. Chong

Research output: Contribution to journalArticle

6 Citations (Scopus)

Abstract

The contribution of T cells and graft-reactive antibodies to acute allograft rejection is widely accepted, but the role of graft-infiltrating B and plasma cells is controversial. We examined 56 consecutive human renal transplant biopsies classified by Banff schema into T-cell-mediated (N = 21), antibody-mediated (N = 18), and mixed (N = 17) acute rejection, using standard immunohistochemistry for CD3, CD20, CD138, and CD45. In a predominantly African-American population (75%), neither Banff classification nor C4d deposition predicted the return to dialysis. Immunohistochemical analysis revealed CD3+ T cells as the dominant cell type, followed by CD20+ B cells and CD138+ plasma cells in all acute rejection types. Using univariate Cox Proportional Hazard analysis, plasma cell density significantly predicted graft failure while B-cell density trended toward significance. Surprisingly T-cell density did not predict graft failure. The estimated glomerular filtration rate (eGFR) at diagnosis of acute rejection also predicted graft failure, while baseline eGFR ≥6 months prior to biopsy did not. Using multivariate analysis, a model including eGFR at biopsy and plasma cell density was most predictive of graft loss. These observations suggest that plasma cells may be a critical mediator and/or an independently sensitive marker of steroid-resistant acute rejection.

Original languageEnglish (US)
Pages (from-to)1050-1058
Number of pages9
JournalTransplant International
Volume25
Issue number10
DOIs
StatePublished - Oct 2012
Externally publishedYes

Fingerprint

Plasma Cells
Glomerular Filtration Rate
Allografts
Cell Count
Transplants
Kidney
T-Lymphocytes
B-Lymphocytes
Biopsy
Antibodies
African Americans
Dialysis
Multivariate Analysis
Immunohistochemistry
Steroids
Population

Keywords

  • allograft rejection
  • B cells
  • immunohistochemistry
  • plasma cells

ASJC Scopus subject areas

  • Transplantation

Cite this

Plasma cell densities and glomerular filtration rates predict renal allograft outcomes following acute rejection. / Chang, Anthony; Moore, Jocelyn M.; Cowan, Michelle L.; Josephson, Michelle A.; Chon, W. James; Sciammas, Roger; Du, Zeying; Marino, Susana R.; Meehan, Shane M.; Millis, Michael; David, Michael Z.; Williams, James W.; Chong, Anita S.

In: Transplant International, Vol. 25, No. 10, 10.2012, p. 1050-1058.

Research output: Contribution to journalArticle

Chang, A, Moore, JM, Cowan, ML, Josephson, MA, Chon, WJ, Sciammas, R, Du, Z, Marino, SR, Meehan, SM, Millis, M, David, MZ, Williams, JW & Chong, AS 2012, 'Plasma cell densities and glomerular filtration rates predict renal allograft outcomes following acute rejection', Transplant International, vol. 25, no. 10, pp. 1050-1058. https://doi.org/10.1111/j.1432-2277.2012.01531.x
Chang, Anthony ; Moore, Jocelyn M. ; Cowan, Michelle L. ; Josephson, Michelle A. ; Chon, W. James ; Sciammas, Roger ; Du, Zeying ; Marino, Susana R. ; Meehan, Shane M. ; Millis, Michael ; David, Michael Z. ; Williams, James W. ; Chong, Anita S. / Plasma cell densities and glomerular filtration rates predict renal allograft outcomes following acute rejection. In: Transplant International. 2012 ; Vol. 25, No. 10. pp. 1050-1058.
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