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
CiteULike 
Connotea 
Del.icio.us What's this?
This article has been cited by other articles:
|
|
 |
|
  D. Sansonno, F. A. Tucci, B. Ghebrehiwet, G. Lauletta, E. I. B. Peerschke, V. Conteduca, S. Russi, P. Gatti, L. Sansonno, and F. Dammacco Role of the Receptor for the Globular Domain of C1q Protein in the Pathogenesis of Hepatitis C Virus-Related Cryoglobulin Vascular Damage J. Immunol., November 1, 2009; 183(9): 6013 - 6020. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 P. Ranjan, R. Nada, V. Jha, V. Sakhuja, and K. Joshi The role of C4d immunostaining in the evaluation of the causes of renal allograft dysfunction Nephrol. Dial. Transplant., May 1, 2008; 23(5): 1735 - 1741. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
D. Dragun and B. Rudolph Novelties in diagnostics and therapy of antibody mediated rejection Nephrol. Dial. Transplant., September 1, 2007; 22(suppl_8): viii50 - viii53. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
D. Dragun Agonistic antibody-triggered stimulation of Angiotensin II type 1 receptor and renal allograft vascular pathology Nephrol. Dial. Transplant., July 1, 2007; 22(7): 1819 - 1822. [Full Text] [PDF]
|
|
|
|
|
|
C. A. Seemayer, A. Gaspert, V. Nickeleit, and M. J. Mihatsch C4d staining of renal allograft biopsies: a comparative analysis of different staining techniques Nephrol. Dial. Transplant., February 1, 2007; 22(2): 568 - 576. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 P. L. Zhang, S. K. Malek, T. M. Blasick, J. R. Pennington, K. K. Masker, M. Lun, and S. Potdar C4d Positivity Is Often Associated with Acute Cellular Rejection in Renal Transplant Biopsies Following Campath-1H (Alemtuzumab) Induction Ann. Clin. Lab. Sci., January 1, 2007; 37(2): 121 - 126. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
N. Imai, S. Nishi, B. Alchi, M. Ueno, S. Fukase, M. Arakawa, K. Saito, K. Takahashi, and F. Gejyo Immunohistochemical evidence of activated lectin pathway in kidney allografts with peritubular capillary C4d deposition Nephrol. Dial. Transplant., September 1, 2006; 21(9): 2589 - 2595. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
A. B. Magil and K. J. Tinckam Focal peritubular capillary C4d deposition in acute rejection Nephrol. Dial. Transplant., May 1, 2006; 21(5): 1382 - 1388. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 M. L. Troxell, L. A. Weintraub, J. P. Higgins, and N. Kambham Comparison of C4d Immunostaining Methods in Renal Allograft Biopsies Clin. J. Am. Soc. Nephrol., May 1, 2006; 1(3): 583 - 591. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
Q. Sun, Z.-H. Liu, G. Yin, H. Chen, J. Chen, S. Ji, and L.-S. Li Tacrolimus combined with mycophenolate mofetil can effectively reverse C4d-positive steroid-resistant acute rejection in Chinese renal allograft recipients Nephrol. Dial. Transplant., February 1, 2006; 21(2): 510 - 517. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 J. R. Ingelfinger Agonistic Autoantibodies and Rejection of Renal Allografts N. Engl. J. Med., February 10, 2005; 352(6): 617 - 619. [Full Text] [PDF]
|
|