Abstract

Abstract Context.—Complement activation, evidenced by deposition of C4d, is important in the diagnosis of antibody-mediated rejection of cardiac allografts. C4d deposition can be assessed by either immunofluorescence (IF)– or immunoperoxidase (IP)–based methods. The use of methods varies considerably among institutions, but there are few data addressing their diagnostic equivalence. Objective.—To compare IF and IP C4d staining on paired endomyocardial biopsy samples from a large number of heart transplant patients. Design.—Retrospectively selected paired frozen and paraffin-embedded samples from the same biopsy were stained for C4d by IF and IP methods. Capillary staining was scored by using a 0, 1+, 2+, 3+ scale. Results.—A total of 296 biopsy pairs from 70 patients were studied. There were two hundred forty-three cases that were scored 0, twenty-four scored 1+, sixteen scored 2+, and thirteen scored 3+ by IF. Two hundred thirty-one cases scored 0, forty scored 1+, ten scored 2+, and fifteen scored 3+ by...

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