Nephrol Dial Transplant (2003) 18: 2232-2239
© 2003 European Renal Association-European Dialysis and Transplant Association
Invited Comment
Kidney transplants, antibodies and rejection: is C4d a magic marker?
1Nephropathology Laboratory, Department of Pathology, University of North Carolina, Chapel Hill, NC, USA and 2Institute for Pathology, University of Basel, Switzerland
Correspondence and offprint requests to: Volker Nickeleit, MD, Nephropathology Laboratory, Department of Pathology, University of North Carolina, Campus Box 7525, Chapel Hill, NC 27599-7525, USA. Email: volker_nickeleit{at}med.unc.edu
Abstract
The immunohistochemical detection of the complement degradation product C4d in renal allograft biopsies has gained considerable clinical interest in recent years. The accumulation of C4d along peritubular capillaries is generally regarded as a marker for an antibody-mediated allo-response and is associated with poor graft survival. The aim of this review is to discuss histological findings associated with the deposition of C4d. Emphasis is placed on diagnostic and therapeutic implications. Unanswered questions regarding C4d and graft injury are highlighted.
Keywords: antibodies; C4d; diagnosis; rejection; therapy
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