BACKGROUND AND OBJECTIVES: Anti-endothelial cell antibody (AECA) can cause hyperacute rejection and immediate graft loss after renal transplantation; however, its prevalence and significance during acute rejection are unknown. Previous studies suggested that AECA may be detected in recipients with acute vascular rejection (AVR). DESIGN, SETTING, PARTICIPANTS, & MEASUREMENTS: We retrospectively analyzed 653 cadaveric renal transplant recipients; circulating AECA was positive in 13 of 47 cases of AVR; another two cases of hyperacute rejection also had detectable AECA. Twenty-six cases of AVR without circulating AECA were selected as controls. RESULTS: AECA-positive AVR usually occurred within 1 yr after transplantation and mostly was resistant to steroid treatment. Compared with the control group, the AECA-positive group was associated with a significantly lower 1-yr graft survival rate (46.7 versus 80.5%; P = 0.038), and more patients had histologic interstitial plasma cell infiltration (53.8 versus 11.5%; P = 0.005). More patients with AECA-positive AVR experienced another one or more episodes of acute rejection during 1 yr of follow-up (75.0 versus 13.0%; P = 0.003). AECA-positive AVR with C4d deposition in peri-tubular capillaries had the worst outcome in this cohort, and it accounted for 38.5% graft loss in AVR. AECA in turn accounted for 71.4% of graft loss in C4d(+) AVR. CONCLUSIONS: Circulating AECA is associated with poor outcome in renal allograft recipients with acute rejection and should be monitored regularly.
BACKGROUND AND OBJECTIVES: Anti-endothelial cell antibody (AECA) can cause hyperacute rejection and immediate graft loss after renal transplantation; however, its prevalence and significance during acute rejection are unknown. Previous studies suggested that AECA may be detected in recipients with acute vascular rejection (AVR). DESIGN, SETTING, PARTICIPANTS, & MEASUREMENTS: We retrospectively analyzed 653 cadaveric renal transplant recipients; circulating AECA was positive in 13 of 47 cases of AVR; another two cases of hyperacute rejection also had detectable AECA. Twenty-six cases of AVR without circulating AECA were selected as controls. RESULTS: AECA-positive AVR usually occurred within 1 yr after transplantation and mostly was resistant to steroid treatment. Compared with the control group, the AECA-positive group was associated with a significantly lower 1-yr graft survival rate (46.7 versus 80.5%; P = 0.038), and more patients had histologic interstitial plasma cell infiltration (53.8 versus 11.5%; P = 0.005). More patients with AECA-positive AVR experienced another one or more episodes of acute rejection during 1 yr of follow-up (75.0 versus 13.0%; P = 0.003). AECA-positive AVR with C4d deposition in peri-tubular capillaries had the worst outcome in this cohort, and it accounted for 38.5% graft loss in AVR. AECA in turn accounted for 71.4% of graft loss in C4d(+) AVR. CONCLUSIONS: Circulating AECA is associated with poor outcome in renal allograft recipients with acute rejection and should be monitored regularly.
Authors: S M Meehan; P Domer; M Josephson; M Donoghue; A Sadhu; L T Ho; A J Aronson; J R Thistlethwaite; M Haas Journal: Hum Pathol Date: 2001-02 Impact factor: 3.466
Authors: Steven K Takemoto; Adriana Zeevi; Sandy Feng; Robert B Colvin; Stanley Jordan; Jon Kobashigawa; Jerzy Kupiec-Weglinski; Arthur Matas; Robert A Montgomery; Peter Nickerson; Jeffrey L Platt; Hamid Rabb; Richard Thistlethwaite; Dolly Tyan; Francis L Delmonico Journal: Am J Transplant Date: 2004-07 Impact factor: 8.086
Authors: Lorraine C Racusen; Robert B Colvin; Kim Solez; Michael J Mihatsch; Philip F Halloran; Patricia M Campbell; Michael J Cecka; Jean-Pierre Cosyns; Anthony J Demetris; Michael C Fishbein; Agnes Fogo; Peter Furness; Ian W Gibson; Denis Glotz; Pekka Hayry; Lawrence Hunsickern; Michael Kashgarian; Ronald Kerman; Alex J Magil; Robert Montgomery; Kunio Morozumi; Volker Nickeleit; Parmjeet Randhawa; Heinz Regele; Daniel Seron; Surya Seshan; Stale Sund; Kiril Trpkov Journal: Am J Transplant Date: 2003-06 Impact factor: 8.086
Authors: Karla Lehle; Johannes Kroher; Philipp Kolat; Marietta von Süßkind-Schwendi; Christof Schmid; Assad Haneya; Leopold Rupprecht; Stephan Hirt Journal: Heart Vessels Date: 2015-03-28 Impact factor: 2.037
Authors: Scott M Sutherland; Li Li; Tara K Sigdel; Persis P Wadia; David B Miklos; Atul J Butte; Minnie M Sarwal Journal: Kidney Int Date: 2009-10-07 Impact factor: 10.612
Authors: Jose M Morales; Jose Angel Martinez-Flores; Manuel Serrano; Maria José Castro; Francisco Javier Alfaro; Florencio García; Miguel Angel Martínez; Amado Andrés; Esther González; Manuel Praga; Estela Paz-Artal; Antonio Serrano Journal: J Am Soc Nephrol Date: 2014-07-28 Impact factor: 10.121
Authors: Roman Reindl-Schwaighofer; Andreas Heinzel; Guido A Gualdoni; Laurent Mesnard; Frans H J Claas; Rainer Oberbauer Journal: Transpl Int Date: 2019-11-28 Impact factor: 3.782