PMID- 26172154
OWN - NLM
STAT- MEDLINE
DCOM- 20160609
LR  - 20191210
IS  - 1399-0012 (Electronic)
IS  - 0902-0063 (Linking)
VI  - 29
IP  - 9
DP  - 2015 Sep
TI  - Plasma cell-rich acute rejections in living-related kidney transplantation: a 
      clinicopathological study of 50 cases.
PG  - 835-41
LID - 10.1111/ctr.12589 [doi]
AB  - BACKGROUND: Acute rejections (ARs) with plasma cell-rich infiltrates (PCARs) are 
      associated with poor outcomes. PATIENTS AND METHODS: Between February 2012 and 
      December 2013, 1630 dysfunctional renal graft biopsies were performed. Of these, 
      50 (3%) showed PCAR. ARs with >10% plasma cells were defined as PCAR. Human 
      leukocyte antigen (HLA) antibodies were tested in historic sera and at the time 
      of PCAR. Treatment for PCAR comprised methylprednisolone, antithymocyte globulin, 
      plasmapheresis, and anti-CD20 antibody. RESULTS: Of the 1630 dysfunctional 
      biopsies, 50 (3%) had PCAR which occurred 3.1 +/- 2.55 yr after transplant. The 
      percentage of plasma cells was 28.8 +/- 11.7, and CD138, 29.0 +/- 12.4. 
      Donor-specific antibodies (DSAs) were found in 32 (64%) overall, Class I in 15% 
      and Class II in 65%. Post-treatment serum creatinine improved from 3.80 +/- 2.59 to 
      2.66 +/- 1.59 mg/dL in DSA positive (p < 0.003) and from 2.59 +/- 1.09 to 2.08 +/- 0.86 
      mg/dL in DSA negative (p < 0.008). One- and two-yr graft survival after PCAR was 
      72%, 42% in the DSA-positive vs. 89%, 82% in the DSA-negative group, respectively 
      (p = 0.071). CONCLUSIONS: Our results show that PCAR occurs late after transplant 
      and in many cases is associated with DSAs. Graft outcome was poor when PCAR was 
      associated with DSAs.
CI  - (c) 2015 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.
FAU - Abbas, Khawar
AU  - Abbas K
AD  - Department of Pathology, Sindh Institute of Urology and Transplantation, Karachi, 
      Pakistan.
FAU - Mubarak, Muhammed
AU  - Mubarak M
AD  - Department of Pathology, Sindh Institute of Urology and Transplantation, Karachi, 
      Pakistan.
FAU - Zafar, Mirza N
AU  - Zafar MN
AD  - Department of Pathology, Sindh Institute of Urology and Transplantation, Karachi, 
      Pakistan.
FAU - Aziz, Tahir
AU  - Aziz T
AD  - Department of Nephrology, Sindh Institute of Urology and Transplantation, 
      Karachi, Pakistan.
FAU - Abbas, Haider
AU  - Abbas H
AD  - Department of Nephrology, Sindh Institute of Urology and Transplantation, 
      Karachi, Pakistan.
FAU - Muzaffar, Rana
AU  - Muzaffar R
AD  - Department of Pathology, Sindh Institute of Urology and Transplantation, Karachi, 
      Pakistan.
FAU - Rizvi, Syed A H
AU  - Rizvi SA
AD  - Department of Urology, Sindh Institute of Urology and Transplantation, Karachi, 
      Pakistan.
LA  - eng
PT  - Journal Article
DEP - 20150731
PL  - Denmark
TA  - Clin Transplant
JT  - Clinical transplantation
JID - 8710240
SB  - IM
MH  - Adolescent
MH  - Adult
MH  - Biopsy
MH  - Child
MH  - Female
MH  - Follow-Up Studies
MH  - Graft Rejection/*immunology/pathology
MH  - Graft Survival
MH  - Humans
MH  - Kidney/*immunology/pathology
MH  - *Kidney Transplantation
MH  - *Living Donors
MH  - Male
MH  - Middle Aged
MH  - Outcome Assessment, Health Care
MH  - Plasma Cells/*immunology
MH  - Retrospective Studies
MH  - Young Adult
OTO - NOTNLM
OT  - acute rejection
OT  - graft outcome
OT  - kidney transplant
OT  - living related
OT  - plasma cell-rich infiltrates
EDAT- 2015/07/15 06:00
MHDA- 2016/06/10 06:00
CRDT- 2015/07/15 06:00
PHST- 2015/07/01 00:00 [accepted]
PHST- 2015/07/15 06:00 [entrez]
PHST- 2015/07/15 06:00 [pubmed]
PHST- 2016/06/10 06:00 [medline]
AID - 10.1111/ctr.12589 [doi]
PST - ppublish
SO  - Clin Transplant. 2015 Sep;29(9):835-41. doi: 10.1111/ctr.12589. Epub 2015 Jul 31.