Volume 12 Issue 3
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Guo Hui. Pathology of antibody-mediated rejection in renal allograft[J]. ORGAN TRANSPLANTATION, 2021, 12(3): 262-271. doi: 10.3969/j.issn.1674-7445.2021.03.003
Citation: Guo Hui. Pathology of antibody-mediated rejection in renal allograft[J]. ORGAN TRANSPLANTATION, 2021, 12(3): 262-271. doi: 10.3969/j.issn.1674-7445.2021.03.003
shu

Pathology of antibody-mediated rejection in renal allograft

doi: 10.3969/j.issn.1674-7445.2021.03.003

  • Organ Transplantation Institute, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Key Laboratory of Organ Transplantation of Ministry of Education, Key Laboratory of Organ Transplantation of National Health Commission of China, Key Laboratory of Organ Transplantation of Chinese Academy of Medical Sciences, Wuhan 430030, China

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  • Corresponding author: Guo Hui, Email: zcguo@tjh.tjmu.edu.cn
  • Received Date: 2021-03-22
    Available Online: 2021-05-19
  • Publish Date: 2021-05-15
    Abstract
  • Antibody-mediated rejection (AMR), also known as humoral rejection, is an immune injury caused by rejection involved with multiple humoral immune effectors, such as antibodies and complements, etc. AMR plays a pivotal role in hyperacute, acute and chronic rejection. In this article, the basic definition of AMR, the research progress and major achievements on AMR pathology according to Banff classification on allograft pathology (Banff classification), and main pathological characteristics of AMR in renal allograft were reviewed, aiming to provide reference for accurate diagnosis and timely treatment of AMR, and guarantee the long-term survival of renal graft and recipients.

     

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  • [1]
    郭晖. 抗体介导性/体液性排斥反应[M]//陈实, 郭晖. 移植病理学. 北京: 人民卫生出版社, 2009.
    [2]
    WILLIAMSON CS. Further studies on the transplantation of the kidney[J]. J Urol, 1926, 16(4): 231-254. doi: 10.1016/S0022-5347(17)73405-2
    [3]
    LEGENDRE CH, KREIS H. A tribute to Jean Hamburger's contribution to organ transplantation[J]. Am J Transplant, 2010, 10(11): 2392-2395. DOI: 10.1111/j.1600-6143.2010.03295.x.
    [4]
    MITCHISON NA. Passive transfer of transplantation immunity[J]. Proc R Soc Lond B Biol Sci, 1954, 142(906): 72-87. DOI: 10.1098/rspb.1954.0007.
    [5]
    MASON DW, MORRIS PJ. Effector mechanism in allograft rejection[J]. Ann Rev Immunol, 1986, 4: 119-145. doi: 10.1146/annurev.iy.04.040186.001003
    [6]
    HALL BM. Cells mediating allograft rejection[J]. Transplantation, 1991, 51(6): 1141-1151. DOI: 10.1097/00007890-199106000-00001.
    [7]
    TING A. The lymphocytotoxic crossmatch test in clinical renal transplantation[J]. Transplantation, 1983, 35(5): 403-407. DOI: 10.1097/00007890-198305000-00001.
    [8]
    PHELAN DL, RODEY GE, FLYE MW, et al. Positive B cell crossmatches: specificity of antibody and graft outcome[J]. Transplant Proc, 1989, 21(1 Pt 1): 687-688. http://www.ncbi.nlm.nih.gov/pubmed/2650222
    [9]
    KARUPPAN SS, LINDHOLM A, MÖLLER E. Characterization and significance of donor-reactive B cell antibodies in current sera of kidney transplant patients[J]. Transplantation, 1990, 49(3): 510-515. DOI: 10.1097/00007890-199003000-00007.
    [10]
    GORER PA. The detection of antigenic differences in mouse erythrocytes by the employment of immune sera[J]. Br J Exp Pathol, 1936, 17(1): 42-50. http://www.ncbi.nlm.nih.gov/pmc/articles/PMC2065193/
    [11]
    GORER PA. The antigenic basis of tumor transplantation[J]. J Pathol Bacteriol, 1938, 47(2): 231-252. doi: 10.1002/path.1700470204
    [12]
    GORER PA, O'GORMAN P. The cytotoxic activity of isoantibodies in mice[J]. Transplant Bull, 1956, 3: 142-143. http://ci.nii.ac.jp/naid/10005183924
    [13]
    KALISS N. Immunological enhancement of tumor homografts in mice: a review[J]. Cancer Res, 1958, 18(9): 992-1003. http://www.ncbi.nlm.nih.gov/pubmed/13596939
    [14]
    VAN ROOD JJ, EERNISSE JG, VAN LEEUWEN A. Leucocyte antibodies in sera from pregnant women[J]. Nature, 1958, 181(4625): 1735-1736. DOI: 10.1038/1811735a0.
    [15]
    STARZL TE. Patterns of permissible donor-recipient tissue transfer in relation to ABO blood groups[M]//HUTHEJ. Experience in renal transplantation. Philadelphia: WB Saunders, 1964.
    [16]
    TERASAKI PI, MCCLELLAND JD. Microdroplet assay of human serum cytotoxins[J]. Nature, 1964, 204: 998-1000. DOI: 10.1038/204998b0.
    [17]
    KISSMEYER-NIELSEN F, OLSEN S, PETERSEN VP, et al. Hyperacute rejection of kidney allografts, associated with pre-existing humoral antibodies against donor cells[J]. Lancet, 1966, 2(7465): 662-665. DOI: 10.1016/s0140-6736(66)92829-7.
    [18]
    PATEL R, TERASAKI PI. Significance of the positive crossmatch test in kidney transplantation[J]. N Engl J Med, 1969, 280(14): 735-739. DOI: 10.1056/NEJM196904032801401.
    [19]
    JEANNET M, PINN VW, FLAX MH, et al. Humoral antibodies in renal allotransplantation in man[J]. N Engl J Med, 1970, 282(3): 111-117. DOI: 10.1056/NEJM197001152820301.
    [20]
    PARK MS, TERASAKI PI, LAU M, et al. Sensitization after transplantation[J]. Clin Transpl, 1987: 393-397.
    [21]
    HALLORAN PF, WADGYMAR A, RITCHIE S, et al. The significance of the anti-class I antibody response. I. clinical and pathologic features of anti-class I-mediated rejection[J]. Transplantation, 1990, 49(1): 85-91. DOI: 10.1097/00007890-199001000-00019.
    [22]
    TRPKOV K, CAMPBELL P, PAZDERKA F, et al. Pathologic features of acute renal allograft rejection associated with donor-specific antibody, analysis using the Banff grading schema[J]. Transplantation, 1996, 61(11): 1586-1592. DOI: 10.1097/00007890-199606150-00007.
    [23]
    FEUCHT HE, FELBER E, GOKEL MJ, et al. Vascular deposition of complement-split products in kidney allografts with cell-mediated rejection[J]. Clin Exp Immunol, 1991, 86(3): 464-470. DOI: 10.1111/j.1365-2249.1991.tb02954.x.
    [24]
    FEUCHT HE, SCHNEEBERGER H, HILLEBRAND G, et al. Capillary deposition of C4d complement fragment and early renal graft loss[J]. Kidney Int, 1993, 43(6): 1333-1338. DOI: 10.1038/ki.1993.187.
    [25]
    COLLINS AB, SCHNEEBERGER EE, PASCUAL MA, et al. Complement activation in acute humoral renal allograft rejection: diagnostic significance of C4d deposits in peritubular capillaries[J]. J Am Soc Nephrol, 1999, 10(10): 2208-2214. doi: 10.1681/ASN.V10102208
    [26]
    BÖHMIG GA, EXNER M, HABICHT A, et al. Capillary C4d deposition in kidney allografts: a specific marker of alloantibody-dependent graft injury[J]. J Am Soc Nephrol, 2002, 13(4): 1091-1099. doi: 10.1681/ASN.V1341091
    [27]
    SOLEZ K, AXELSEN RA, BENEDIKTSSON H, et al. International standardization of criteria for the histologic diagnosis of renal allograft rejection: the Banff working classification of kidney transplant pathology[J]. Kidney Int, 1993, 44(2): 411-422. DOI: 10.1038/ki.1993.259.
    [28]
    HALLORAN PF, SCHLAUT J, SOLEZ K, et al. The significance of the anti-class I response. Ⅱ. clinical and pathologic features of renal transplants with anti-class I-like antibody[J]. Transplantation, 1992, 53(3): 550-555. doi: 10.1097/00007890-199203000-00011
    [29]
    ROSE SM, STRICKLAND PS, ALDERSON C. Cooperative clinical trial in adult transplantation[J]. NIH Guide, 1995, 24(6): 1-25.
    [30]
    RACUSEN LC, HALLORAN PF, SOLEZ K. Banff 2003 meeting report: new diagnostic insights and standards[J]. Am J Transplant, 2004, 4(10): 1562-1566. DOI: 10.1111/j.1600-6143.2004.00585.x.
    [31]
    SOLEZ K, COLVIN RB, RACUSEN LC, et al. Banff '05 meeting report: differential diagnosis of chronic allograft injury and elimination of chronic allograft nephropathy ('CAN')[J]. Am J Transplant, 2007, 7(3): 518-526. DOI: 10.1111/j.1600-6143.2006.01688.x.
    [32]
    SOLEZ K, COLVIN RB, RACUSEN LC, et al. Banff 07 classification of renal allograft pathology: updates and future directions[J]. Am J Transplant, 2008, 8(4): 753-760. DOI: 10.1111/j.1600-6143.2008.02159.x.
    [33]
    JABS WJ, SEDLMEYER A, RAMASSAR V, et al. Heterogeneity in the evolution and mechanisms of the lesions of kidney allograft rejection in mice[J]. Am J Transplant, 2003, 3(12): 1501-1509. DOI: 10.1046/j.1600-6135.2003.00269.x.
    [34]
    SIS B, JHANGRI GS, BUNNAG S, et al. Endothelial gene expression in kidney transplants with alloantibody indicates antibody-mediated damage despite lack of C4d staining[J]. Am J Transplant, 2009, 9(10): 2312-2323. DOI: 10.1111/j.1600-6143.2009.02761.x.
    [35]
    GLOOR JM, COSIO FG, REA DJ, et al. Histologic findings one year after positive crossmatch or ABO blood group incompatible living donor kidney transplantation[J]. Am J Transplant, 2006, 6(8): 1841-1847. DOI: 10.1111/j.1600-6143.2006.01416.x.
    [36]
    SIS B, REEVE J, EINECKE G, et al. Endothelial stress accelerates graft loss in kidneys with transplant glomerulopathy despite lack of C4d staining[J]. Am J Transplant, 2009, 9(Suppl 2): 349. http://www.researchgate.net/publication/278238899_Endothelial_Stress_Accelerates_Graft_Loss_in_Kidneys_with_Transplant_Glomerulopathy_Despite_Lack_of_C4D_Staining
    [37]
    WAVAMUNNO MD, O'CONNELL PJ, VITALONE M, et al. Transplant glomerulopathy: ultrastructural abnormalities occur early in longitudinal analysis of protocol biopsies[J]. Am J Transplant, 2007, 7(12): 2757-2768. DOI: 10.1111/j.1600-6143.2007.01995.x.
    [38]
    MICHAELS PJ, FISHBEIN MC, COLVIN RB. Humoral rejection of human organ transplants[J]. Springer Semin Immunopathol, 2003, 25(2): 119-140. DOI: 10.1007/s00281-003-0139-x.
    [39]
    MENGEL M, SIS B, HAAS M, et al. Banff 2011 meeting report: new concepts in antibody-mediated rejection[J]. Am J Transplant, 2012, 12(3): 563-570. DOI: 10.1111/j.1600-6143.2011.03926.x.
    [40]
    LOUPY A, SUBERBIELLE-BOISSEL C, HILL GS, et al. Outcome of subclinical antibody-mediated rejection in kidney transplant recipients with preformed donor-specific antibodies[J]. Am J Transplant, 2009, 9(11): 2561-2570. DOI: 10.1111/j.1600-6143.2009.02813.x.
    [41]
    LOUPY A, HILL GS, SUBERBIELLE C, et al. Significance of C4d Banff scores in early protocol biopsies of kidney transplant recipients with preformed donor-specific antibodies (DSA)[J]. Am J Transplant, 2011, 11(1): 56-65. DOI: 10.1111/j.1600-6143.2010.03364.x.
    [42]
    COSIO FG, LAGER DJ, LORENZ EC, et al. Significance and implications of capillaritis during acute rejection of kidney allografts[J]. Transplantation, 2010, 89(9): 1088-1094. DOI: 10.1097/TP.0b013e3181d368f1.
    [43]
    COSIO FG, GLOOR JM, SETHI S, et al. Transplant glomerulopathy[J]. Am J Transplant, 2008, 8(3): 492-496. DOI: 10.1111/j.1600-6143.2007.02104.x.
    [44]
    HAYDE N, BAO Y, PULLMAN J, et al. The clinical and molecular significance of C4d staining patterns in renal allografts[J]. Transplantation, 2013, 95(4): 580-588. DOI: 10.1097/TP.0b013e318277b2e2.
    [45]
    EINECKE G, SIS B, REEVE J, et al. Antibody-mediated microcirculation injury is the major cause of late kidney transplant failure[J]. Am J Transplant, 2009, 9(11): 2520-2531. DOI: 10.1111/j.1600-6143.2009.02799.x.
    [46]
    SIS B, JHANGRI GS, RIOPEL J, et al. A new diagnostic algorithm for antibody-mediated microcirculation inflammation in kidney transplants[J]. Am J Transplant, 2012, 12(5): 1168-1179. DOI: 10.1111/j.1600-6143.2011.03931.x.
    [47]
    GUPTA A, BROIN PÓ, BAO Y, et al. Clinical and molecular significance of microvascular inflammation in transplant kidney biopsies[J]. Kidney Int, 2016, 89(1): 217-225. DOI: 10.1038/ki.2015.276.
    [48]
    HAAS M. Pathology of C4d-negative antibody-mediated rejection in renal allografts[J]. Curr Opin Organ Transplant, 2013, 18(3): 319-326. DOI: 10.1097/MOT.0b013e32835d4daf.
    [49]
    HAAS M, MIROCHA J. Early ultrastructural changes in renal allografts: correlation with antibody-mediated rejection and transplant glomerulopathy[J]. Am J Transplant, 2011, 11(10): 2123-2131. DOI: 10.1111/j.1600-6143.2011.03647.x.
    [50]
    STEGALL MD, DIWAN T, RAGHAVAIAH S, et al. Terminal complement inhibition decreases antibody-mediated rejection in sensitized renal transplant recipients[J]. Am J Transplant, 2011, 11(11): 2405-2413. DOI: 10.1111/j.1600-6143.2011.03757.x.
    [51]
    PAPADIMITRIOU JC, DRACHENBERG CB, RAMOS E, et al. Antibody-mediated allograft rejection: morphologic spectrum and serologic correlations in surveillance and for cause biopsies[J]. Transplantation, 2013, 95(1): 128-136. DOI: 10.1097/TP.0b013e3182777f28.
    [52]
    LEFAUCHEUR C, LOUPY A, VERNEREY D, et al. Antibody-mediated vascular rejection of kidney allografts: a population-based study[J]. Lancet, 2013, 381(9863): 313-319. DOI: 10.1016/S0140-6736(12)61265-3.
    [53]
    DRAGUN D, MÜLLER DN, BRÄSEN JH, et al. Angiotensin Ⅱ type 1-receptor activating antibodies in renal-allograft rejection[J]. N Engl J Med, 2005, 352(6): 558-569. DOI: 10.1056/NEJMoa035717.
    [54]
    REINSMOEN NL, LAI CH, MIROCHA J, et al. Increased negative impact of donor HLA-specific together with non-HLA-specific antibodies on graft outcome[J]. Transplantation, 2014, 97(5): 595-601. DOI: 10.1097/01.TP.0000436927.08026.a8.
    [55]
    ZHANG Q, REED EF. The importance of non-HLA antibodies in transplantation[J]. Nat Rev Nephrol, 2016, 12(8): 484-495. DOI: 10.1038/nrneph.2016.88.
    [56]
    CHEN G, SEQUEIRA F, TYAN DB. Novel C1q assay reveals a clinically relevant subset of human leukocyte antigen antibodies independent of immunoglobulin G strength on single antigen beads[J]. Hum Immunol, 2011, 72(10): 849-858. DOI: 10.1016/j.humimm.2011.07.001.
    [57]
    YABU JM, HIGGINS JP, CHEN G, et al. C1q-fixing human leukocyte antigen antibodies are specific for predicting transplant glomerulopathy and late graft failure after kidney transplantation[J]. Transplantation, 2011, 91(3): 342-347. DOI: 10.1097/TP.0b013e318203fd26.
    [58]
    LOUPY A, LEFAUCHEUR C, VERNEREY D, et al. Complement-binding anti-HLA antibodies and kidney-allograft survival[J]. N Engl J Med, 2013, 369(13): 1215-1226. DOI: 10.1056/NEJMoa1302506.
    [59]
    SICARD A, DUCREUX S, RABEYRIN M, et al. Detection of C3d-binding donor-specific anti-HLA antibodies at diagnosis of humoral rejection predicts renal graft loss[J]. J Am Soc Nephrol, 2015, 26(2): 457-467. DOI: 10.1681/ASN.2013101144.
    [60]
    SÜSAL C, WETTSTEIN D, DÖHLER B, et al. Association of kidney graft loss with de novo produced donor-specific and non-donor-specific HLA antibodies detected by single antigen testing[J]. Transplantation, 2015, 99(9): 1976-1980. DOI: 10.1097/TP.0000000000000672.
    [61]
    FICHTNER A, SÜSAL C, HÖCKER B, et al. Association of C1q-fixing DSA with late graft failure in pediatric renal transplant recipients[J]. Pediatr Nephrol, 2016, 31(7): 1157-1166. DOI: 10.1007/s00467-016-3322-8.
    [62]
    HIDALGO LG, SIS B, SELLARES J, et al. NK cell transcripts and NK cells in kidney biopsies from patients with donor-specific antibodies: evidence for NK cell involvement in antibody-mediated rejection[J]. Am J Transplant, 2010, 10(8): 1812-1822. DOI: 10.1111/j.1600-6143.2010.03201.x.
    [63]
    NICKELEIT V, ZEILER M, GUDAT F, et al. Detection of the complement degradation product C4d in renal allografts: diagnostic and therapeutic implications[J]. J Am Soc Nephrol, 2002, 13(1): 242-251. doi: 10.1681/ASN.V131242
    [64]
    WIEBE C, GIBSON IW, BLYDT-HANSEN TD, et al. Rates and determinants of progression to graft failure in kidney allograft recipients with de novo donor-specific antibody[J]. Am J Transplant, 2015, 15(11): 2921-2930. DOI: 10.1111/ajt.13347.
    [65]
    LOUPY A, VERNEREY D, TINEL C, et al. Subclinical rejection phenotypes at 1 year post-transplant and outcome of kidney allografts[J]. J Am Soc Nephrol, 2015, 26(7): 1721-1731. DOI: 10.1681/ASN.2014040399.
    [66]
    LOUPY A, HAAS M, SOLEZ K, et al. The Banff 2015 kidney meeting report: current challenges in rejection classification and prospects for adopting molecular pathology[J]. Am J Transplant, 2017, 17(1): 28-41. DOI: 10.1111/ajt.14107.
    [67]
    HAAS M, LOUPY A, LEFAUCHEUR C, et al. The Banff 2017 kidney meeting report: revised diagnostic criteria for chronic active T cell-mediated rejection, antibody-mediated rejection, and prospects for integrative endpoints for next-generation clinical trials[J]. Am J Transplant, 2018, 18(2): 293-307. DOI: 10.1111/ajt.14625.
    [68]
    LOUPY A, HAAS M, ROUFOSSE C, et al. The Banff 2019 kidney meeting report (Ⅰ): updates on and clarification of criteria for T cell- and antibody-mediated rejection[J]. Am J Transplant, 2020, 20(9): 2318-2331. DOI: 10.1111/ajt.15898.
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