BACKGROUND: Complement staining as a predictor of antibody-mediated rejection (AMR) after lung transplantation continues to be debated. METHODS: In a cohort of 33 lung transplant recipients (LTRs) we assessed early post-transplant (<or=3 months) graft deposition of the complement factors C3d and C4d and correlated staining with clinical outcome. A retrospective analysis of allograft C3d and C4d deposition was performed by an experienced histopathologist blinded to clinical outcomes. Biopsies were graded 0 to 3 based on extent of septal capillary complement staining. RESULTS: Significant C3d and C4d staining (i.e., Grade >or=2 on more than one occasion) was observed in 20 and 11 LTRs, respectively. Complement staining was increased in LTRs with severe primary graft dysfunction or airway infection, but was not associated with acute cellular or chronic rejection, or with morphologic features of AMR. In a sub-group analysis we identified 9 LTRs who developed early bronchiolitis obliterans syndrome (BOS) in the absence of acute cellular rejection or cytomegalovirus reactivation, but they had significant lung allograft C3d/C4d deposition along with corroborative light-microscopic features suggestive of AMR. CONCLUSIONS: Complement activation, as judged by lung allograft deposition of C3d/C4d, is common early post-lung transplant and may be triggered by primary graft dysfunction and/or airway infection, and may play a role in the development of early BOS.
BACKGROUND: Complement staining as a predictor of antibody-mediated rejection (AMR) after lung transplantation continues to be debated. METHODS: In a cohort of 33 lung transplant recipients (LTRs) we assessed early post-transplant (<or=3 months) graft deposition of the complement factors C3d and C4d and correlated staining with clinical outcome. A retrospective analysis of allograft C3d and C4d deposition was performed by an experienced histopathologist blinded to clinical outcomes. Biopsies were graded 0 to 3 based on extent of septal capillary complement staining. RESULTS: Significant C3d and C4d staining (i.e., Grade >or=2 on more than one occasion) was observed in 20 and 11 LTRs, respectively. Complement staining was increased in LTRs with severe primary graft dysfunction or airway infection, but was not associated with acute cellular or chronic rejection, or with morphologic features of AMR. In a sub-group analysis we identified 9 LTRs who developed early bronchiolitis obliterans syndrome (BOS) in the absence of acute cellular rejection or cytomegalovirus reactivation, but they had significant lung allograft C3d/C4d deposition along with corroborative light-microscopic features suggestive of AMR. CONCLUSIONS: Complement activation, as judged by lung allograft deposition of C3d/C4d, is common early post-lung transplant and may be triggered by primary graft dysfunction and/or airway infection, and may play a role in the development of early BOS.
Authors: Danielle Cohen; Robert B Colvin; Mohamed R Daha; Cinthia B Drachenberg; Mark Haas; Volker Nickeleit; Jane E Salmon; Banu Sis; Ming-Hui Zhao; Jan A Bruijn; Ingeborg M Bajema Journal: Kidney Int Date: 2012-02-01 Impact factor: 10.612
Authors: Angali Golocheikine; Dilip S Nath; Haseeb Ilias Basha; Deepti Saini; Donna Phelan; Aviva Aloush; Elbert P Trulock; Ramsey R Hachem; G Alexander Patterson; Joseph M Ahearn; Thalachallour Mohanakumar Journal: J Heart Lung Transplant Date: 2010-04 Impact factor: 10.247
Authors: Laurie D Snyder; Ziwei Wang; Dong-Feng Chen; Nancy L Reinsmoen; C Ashley Finlen-Copeland; W Austin Davis; David W Zaas; Scott M Palmer Journal: Chest Date: 2013-07 Impact factor: 9.410
Authors: Hongmei Gu; Amanda J Fisher; Elizabeth A Mickler; Frank Duerson; Oscar W Cummings; Marc Peters-Golden; Homer L Twigg; Trent M Woodruff; David S Wilkes; Ragini Vittal Journal: FASEB J Date: 2016-03-08 Impact factor: 5.191
Authors: Matthew M DeNicola; Sam S Weigt; John A Belperio; Elaine F Reed; David J Ross; W Dean Wallace Journal: J Heart Lung Transplant Date: 2013-01-10 Impact factor: 10.247