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Updated: Aug 26, 2026
In Vitro and In Vivo Assessment of T, B and Myeloid Cells Suppressive Activity and Humoral Responses from Transplant Recipients
Published on: August 12, 2017
[Complement split product C4 as the indicator of immunological activity in chronic allograft rejection]
Andrzej Mróz1, Magdalena Durlik, Tomasz Cieciura
1Klinika Medycyny Transplantacyjnej i Nefrologii AM w Warszawie.
Insights
Complement split product C4d expression indicates immunological activity in chronic kidney transplant rejection. Higher C4d levels correlate with rejection episodes and improved outcomes after intensified immunosuppression.
Area of Science:
- Nephrology
- Immunology
- Transplantation
Context:
- Deteriorating graft function post-renal transplantation requires accurate diagnostic markers.
- Distinguishing immunological activity in chronic rejection is crucial for patient management.
Purpose:
- To evaluate the utility of stable complement split product C4d expression as an independent indicator of immunological activity in chronic kidney transplant rejection.
- To assess the correlation between C4d expression and clinical outcomes.
Summary:
- Stable complement split product C4d expression was assessed using immunofluorescence on fresh frozen tissue from renal transplant recipients with declining graft function.
- Patients received intensified immunosuppression, with azathioprine replaced by mycofenolate mofetil.
- A positive correlation was observed between C4d expression, prior acute rejection episodes, and chronic rejection morphology.
- C4d expression also correlated with clinical improvement following enhanced immunosuppression.
Impact:
- C4d expression serves as a valuable biomarker for immunological activity in chronic kidney transplant rejection.
- Findings support the use of C4d as an independent indicator to guide treatment strategies.
- This research aids in optimizing immunosuppressive therapy and improving long-term graft survival.
Abstract:
The patients after renal transplantation with deteriorating graft function were included to the study. The aim of the study was to establish the usefulness of stabile complement split product C4d expression as the independent indicator of immunological activity in chronic rejection. The C4d expression was studied on fresh frozen tissue with immunofluorescence method. The intensification of immunosuppression regimen was also introduced and azathioprine was exchanged with mycofenolate mofetil. The protocol biopsies a year after inclusion are planned to be done. In our study there was positive correlation between C4d expression and previous acute rejection episodes, morphological changes specific for chronic rejection and clinical improvement after immunosuppression enhancement.
