Antibodies directed against tubular basement membranes in human renal allograft recipients

Abstract

Among 101 renal allograft recipients, 4 were found who had circulating IgG antibodies of various subclasses directed against the tubular basement membrane (TBM) of the graft, IgG 4 was demonstrated along the TBM without C3 and tubulo-interstitial changes TBM of renal medullary tissue. When tested against a panel of kidney biopsies, the anti-TBM antibodies bound to almost all kidneys. The effects of the antibodies could be studied in three of the four recipients, since one graft was removed for technical reasons 1 day after transplantation. In two grafts tubulo-interstitial changes developed but there was no specific binding of IgG along the TBM, which raises the question as to whether the histological changes were at all related to the circulating anti-TBM antibodies. In one graft, IgG 4 was demonstrated along the TBM without C3 and tubulo-interstitial changes did not develop.