Abstract
CD20 Expression in the Transplanted Kidney of Patients with Graft Loss and Transient Allograft Dysfunction This study aimed to explore the relationship between the infiltration of CD20+ B cells and the survival time of a renal allograft and to investigate the role of infiltrated B cells in the rejection of the renal allograft. A total of 40 patients with renal allograft loss due to refractory rejection and 20 patients with transient renal allograft dysfunction were recruited. Renal biopsy was done and CD20 expression was detected by immunohistochemistry. In addition, the survival time of the renal allograft was also obtained. The relationships between the CD20 expression and the survival time of the renal allograft and graft loss due to rejection were analyzed. The associations of gender, age and clinicopathogical types with the CD20 expression were also investigated. The proportion of patients positive for CD20 in the transplanted kidney was higher in patients receiving nephrectomy of the allograft due to rejection than in those with transient allograft dysfunction. The diffuse infiltration of CD20+ B cells was considered as positive staining. In 40 samples from patients with graft loss, 19 had diffuse infiltration of CD20+ B cells (47.5%). In 19 patients positive for CD20, hyperacute rejection was found in 1 patient, acute rejection in 5 and chronic rejection in 13. Statistical analysis showed the CD20 expression was not associated with the age and gender of donors and recipients, regimen for immunosuppressive treatment, cold/warm ischemia time and secondary transplantation. CD20+ B cell infiltration predicts a poor prognosis of patients with kidney transplantation and is one of the risk factors of graft loss.
Highlights
Kidney transplantation has undergone development for more than 50 years
In 40 patients with graft loss, were positive for CD20 (47.5%), and 2 (10.0%) were positive for CD20 in patients with transient dysfunction of the transplanted kidney
Of 40 patients undergoing graft loss whose survival time was less than 5 years, 13 were positive for CD20, accounting for 68.4% of the patients positive for CD20
Summary
Kidney transplantation has undergone development for more than 50 years. Currently, it is an effective strategy for the treatment of renal failure. In 2005, Hippen et al [1] found the CD20 expression aggregated in the transplanted kidney showing the infiltration of B cells in the allograft which may be a cause of the poor prognosis of patients undergoing kidney transplantation. In 2006, Doria et al [2] reported the infiltration of B cells was unlikely related to the poor prognosis of patients with kidney transplantation. It will be seen from this paper that there is still controversy on the role of B cell infiltration in the allograft dysfunction. Our study aimed to investigate the role of B cell infiltration in the allograft survival and loss
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