Affordable Access

deepdyve-link
Publisher Website

Complement fragment C4d and C3d deposition in pediatric heart recipients with a positive crossmatch.

Authors
  • Holt, Dudley B1
  • Liapis, Helen
  • Mohanakumar, Thalchallour
  • Phelan, Donna R
  • Gandi, Sanjiv K
  • Huddleston, Charles B
  • Canter, Charles E
  • 1 Departments of Pediatrics, Pathology and Surgery, Washington University School of Medicine, St. Louis, Missouri 63110-1014, USA.
Type
Published Article
Journal
The Journal of heart and lung transplantation : the official publication of the International Society for Heart Transplantation
Publication Date
Oct 01, 2008
Volume
27
Issue
10
Pages
1073–1078
Identifiers
DOI: 10.1016/j.healun.2008.07.013
PMID: 18926396
Source
Medline
Language
English
License
Unknown

Abstract

Pediatric heart transplant recipients with a positive complement-dependent cytotoxic (CDC) donor-recipient crossmatch are at high risk for rejection. We sought to correlate the pattern of C3d and C4d myocardial capillary deposition and pericapillary macrophage infiltration, possible markers of antibody-mediated rejection, to clinical evidence of rejection in these patients. Were studied 15 pre-sensitized pediatric patients who had 21 rejection episodes, as defined by International Society for Heart and Lung Transplantation (ISHLT) biopsy Grade >or=2R and/or the development of abnormal left ventricular (LV) function at >1 week after transplant. Archived paraffin-embedded endomyocardial biopsies (n = 74) from these patients were subjected to immunoperoxidase staining for C3d, C4d and CD68 in duplicate. Positive and negative controls were included for each assay. C3d deposition was present in 74 of 74 (100%) specimens. C4d deposition was present in 6 of 74 (8%) biopsies from 4 patients. Biopsies with C4d deposition had ISHLT Grade >or=2R cellular infiltration in 5 of 6 specimens. Pericapillary macrophage infiltration, defined as positive staining for CD68, was found in 34 of 74 (46%) biopsies, and was associated with ISHLT Grade >or=2R in 10 of 34 (29%). C3d deposition was universally present after heart transplantation with a CDC(+) donor/recipient crossmatch. C4d deposition and pericapillary macrophage infiltration were found with some, but not all, episodes of rejection. Further study is needed to understand the significance of the presence of complement fragments and pericapillary macrophage infiltration in these endomyocardial biopsies.

Report this publication

Statistics

Seen <100 times