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Updated: Mar 16, 2026

Mouse Kidney Transplantation: Models of Allograft Rejection
Published on: October 11, 2014
Evaluation of Microvascular Inflammation in ABO-Incompatible Kidney Transplantation
Hiroki Ishihara1, Hideki Ishida, Kohei Unagami
11 Department of Urology, Kidney Center, Tokyo Women's Medical University, Shinjuku-ku, Tokyo, Japan. 2 Department of Nephrology, Kidney Center, Tokyo Women's Medical University, Shinjuku-ku, Tokyo, Japan.
Background:
In ABO-incompatible kidney transplantation, the diagnostic criteria for antibody-mediated rejection remain controversial because C4d deposition is commonly observed. Thus, we investigated microvascular inflammation (MVI score ≥ 2) within 1 year as a predictor of graft outcome.
Methods:
A total of 148 recipients without preformed or de novo donor-specific anti-HLA antibody were stratified based on MVI score less than 2 (n = 117) and MVI score of 2 or greater (n = 31).
Results:
We found that 5-year graft survival was significantly lower (P = 0.0129) in patients with MVI (89.8%) than in patients without MVI (97.0%). Graft function, as characterized by serum estimated glomerular filtration rate, was also significantly worse for patients with MVI than it was for patients without MVI, between 3 months and 10 years after transplantation (P = 0.048). Multivariate analysis indicated that HLA class II mismatch (P = 0.0085) was an independent marker of MVI.
Conclusions:
Microvascular inflammation score of 2 or greater is significantly associated with poor graft outcome after ABO-incompatible kidney transplantation. We suggest that MVI score of 2 or greater in ABOi transplantation be used as a basis to diagnose antibody-mediated rejection.
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