PMID- 24164556
OWN - NLM
STAT- MEDLINE
DCOM- 20140926
LR  - 20151119
IS  - 1543-2165 (Electronic)
IS  - 0003-9985 (Linking)
VI  - 138
IP  - 8
DP  - 2014 Aug
TI  - The presence of anti-HLA donor-specific antibodies in lung allograft recipients 
      does not correlate with C4d immunofluorescence in transbronchial biopsy 
      specimens.
PG  - 1053-8
LID - 10.5858/arpa.2013-0539-OA [doi]
AB  - CONTEXT: C4d immunofluorescence (IF) is a surrogate for development of 
      donor-specific antibodies (DSAs) against human leukocyte antigen (HLA) class I 
      and II antigens in kidney and heart biopsy specimens for monitoring of 
      antibody-mediated (humoral) allograft rejection (AMR). Use of C4d IF in 
      monitoring of lung allografts has shown conflicting results. OBJECTIVE: To 
      determine if C4d IF can be used as a reliable marker for AMR and if it correlates 
      with the presence of DSAs and histologic findings on biopsy. DESIGN: All 
      transbronchial biopsies in lung allograft recipients, performed at our 
      institution in a 3-year period, were reviewed. A cohort of 92 patients with 110 
      corresponding biopsies met the inclusion criteria of (1) having a resulted DSA 
      within 2 weeks of biopsy and (2) having C4d immunofluorescence studies performed 
      and confirmed. RESULTS: Twenty-nine patients (31.5%) were positive for DSAs and 
      63 patients (68.5%) did not develop DSAs. Positive C4d capillary IF was seen in 
      18 of 110 total biopsy specimens (16.4%). Eight of these biopsy samples were from 
      patients positive for DSAs and 10 were from patients negative for DSAs. The 
      correlation coefficient between the presence of DSAs and C4d IF was 0.1628 (P = 
      .09). CONCLUSIONS: A significant proportion of DSA-positive patients had negative 
      C4d IF results and frequently have no histologic changes on biopsy specimens. 
      DSA-negative patients can be positive for C4d and may show the same histologic 
      changes as reported for DSA-positive patients. Diagnosis of AMR in lung may 
      require a collaborative approach combining clinical data, DSA status, and 
      histology.
FAU - Roberts, Jordan A
AU  - Roberts JA
AD  - From the Department of Pathology and Genomic Medicine, Houston Methodist 
      Hospital, Houston, Texas (Drs Roberts, Barrios, Cagle, Ge, Takei, Haque, Burns, 
      Land, Dilioglou, and Bernard); and the Department of Pathology, Weill Cornell 
      Medical College of Cornell University, Houston, Texas (Drs Barrios, Cagle, Ge, 
      and Takei).
FAU - Barrios, Roberto
AU  - Barrios R
FAU - Cagle, Philip T
AU  - Cagle PT
FAU - Ge, Yimin
AU  - Ge Y
FAU - Takei, Hidehiro
AU  - Takei H
FAU - Haque, Abida K
AU  - Haque AK
FAU - Burns, Kevin M
AU  - Burns KM
FAU - Land, Geoffrey A
AU  - Land GA
FAU - Dilioglou, Smaroula
AU  - Dilioglou S
FAU - Bernard, David W
AU  - Bernard DW
LA  - eng
PT  - Journal Article
DEP - 20131028
PL  - United States
TA  - Arch Pathol Lab Med
JT  - Archives of pathology & laboratory medicine
JID - 7607091
RN  - 0 (Biomarkers)
RN  - 0 (HLA Antigens)
RN  - 0 (Isoantibodies)
RN  - 0 (Peptide Fragments)
RN  - 80295-50-7 (Complement C4b)
RN  - 80295-52-9 (complement C4d)
SB  - IM
MH  - Adult
MH  - Aged
MH  - Biomarkers/metabolism
MH  - Biopsy
MH  - Bronchi/immunology/*metabolism/pathology
MH  - Cohort Studies
MH  - Complement C4b/*metabolism
MH  - Female
MH  - Fluorescent Antibody Technique, Direct
MH  - Follow-Up Studies
MH  - HLA Antigens/*metabolism
MH  - Hospitals, Religious
MH  - *Host vs Graft Reaction
MH  - Humans
MH  - *Immunity, Humoral
MH  - Isoantibodies/*metabolism
MH  - Lung Transplantation/*adverse effects
MH  - Male
MH  - Middle Aged
MH  - Peptide Fragments/*metabolism
MH  - Texas
MH  - Transplantation, Homologous
EDAT- 2013/10/30 06:00
MHDA- 2014/09/27 06:00
CRDT- 2013/10/30 06:00
PHST- 2013/10/30 06:00 [entrez]
PHST- 2013/10/30 06:00 [pubmed]
PHST- 2014/09/27 06:00 [medline]
AID - 10.5858/arpa.2013-0539-OA [doi]
PST - ppublish
SO  - Arch Pathol Lab Med. 2014 Aug;138(8):1053-8. doi: 10.5858/arpa.2013-0539-OA. Epub 
      2013 Oct 28.