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Capillary deposition of complement C4d and C3d in Chinese renal allograft biopsies
Rong Lv1, Wei Zhang1, Fei Han1
1Kidney Disease Center, The First Affiliated Hospital, College of Medicine, Zhejiang University, Hangzhou, Zhejiang 310003, China ; Key Laboratory of Nephropathy, Hangzhou, Zhejiang 310003, China ; Kidney Disease Immunology Laboratory, The Third Grade Laboratory, State Administration of Traditional Chinese Medicine, Hangzhou, Zhejiang 310003, China ; Key Laboratory of Multiple Organ Transplantation, Ministry of Health, Hangzhou, Zhejiang 310003, China.
Insights
Complement component 3d (C3d) deposition in peritubular capillaries (PTC) is linked to worse kidney transplant outcomes. This study highlights C3d
Area of Science:
- Nephrology
- Transplantation Immunology
- Pathology
Background:
- The role of complement component 3d (C3d) in renal biopsies and its impact on long-term graft survival is not well understood.
- C3d is a product of both the classic and alternative complement pathways.
Purpose of the Study:
- To investigate the association between C3d deposition in peritubular capillaries (PTC) and long-term graft survival in kidney transplant recipients.
- To explore the relationship between C3d deposition, C4d deposition, histological findings, and clinical outcomes.
Main Methods:
- A cohort study including 94 patients with biopsy-proven acute rejection episodes.
- Analysis of histological findings, clinical examinations, and patient outcomes.
- Assessment of C3d and C4d deposition in PTC.
Main Results:
- The prevalence of C3dPTC and C4dPTC was 29.8% and 42.6%, respectively, with a significant association between them.
- Both C3dPTC and C4dPTC were related to histological types.
- Graft survival was significantly lower in patients with C3dPTC, particularly in those with double positivity for C3dPTC and C4dPTC.
Conclusions:
- C3d deposition in PTC is closely related to renal dysfunction and pathological changes in kidney transplant recipients.
- C3d deposition is a significant predictor of poor long-term graft survival.
Background:
C3d is a product of both the classic and the alternative complement cascades; however, few studies have addressed the role of C3d in renal biopsies and its relationship with long-term graft survival rate is not very clear.
Methods:
94 patients with biopsy-proven acute rejection episodes were included in the study. We investigated the associations between histological findings, clinical examinations, and outcome.
Results:
The overall prevalence for C4dPTC and C3dPTC was 42.6% and 29.8%. There was a significant association between C3dPTC and C4dPTC (P < 0.001). C3dPTC and C4dPTC were related with histological types (P = 0.024 and P < 0.001, resp.). The long-term survival rate for C4dPTC positive transplants was lower than that of C4dPTC negative transplants, but it was not statistic significant in our study (P = 0.150). The survival rate of C3dPTC positive group was much lower than the negative group (P = 0.014). Patients with double positives for C4dPTC and C3dPTC exhibited the lowest survival rate significantly different from those of the C3dPTC only and C4dPTC only groups (P = 0.01 and P = 0.0037).
Conclusions:
This longitudinal cohort study has demonstrated that C3d deposition in the PTC was closely related to renal dysfunction and pathological changes.
