Evaluation of C4d staining in liver and small intestine allografts

Megan Troxell, John P. Higgins, Neeraja Kambham

Research output: Contribution to journalArticle

58 Citations (Scopus)

Abstract

Context. - Antibody-mediated humoral rejection in kidney and heart allografts is well recognized and is often associated with poor outcome. C4d deposition in allograft biopsy specimens occurs at sites of antibody-mediated complement activation and has become one of the histopathologic criteria for diagnosis of humoral rejection in the kidney and the heart. Objective. - To study immunohistochemical C4d staining as a potential diagnostic marker in liver and small intestine allograft biopsy specimens. Design. - Thirty-six small intestine and 71 liver specimens, including native specimens, allografts with and without histologic features of acute cellular rejection, and explants, were stained with antisera to C4d using an immunohistochemical method on formalin-fixed, paraffin-embedded tissue. Results. - In small intestine, C4d labeled capillaries in 27% of cases with no evidence of rejection, 36% of cases with evidence of acute rejection, and 2 (28%) of 7 specimens of native normal small intestine, in liver allograft biopsy specimens, C4d stained endothelium of veins, arteries, and/or sinusoids in 2 (8%) of 25 cases of acute rejection with central vein involvement; C4d staining was negative in biopsy specimens with no evidence of rejection. C4d stained the endothelium in a subset of explanted liver allografts with ductopenic rejection or chronic vascular rejection and strongly stained 1 explant with features of hyperacute rejection. Conclusions. - The clinical utility of C4d staining in solid organ transplantation may vary by organ. Our data show C4d is unlikely to have utility in small intestine allograft biopsy specimens; however, further study in liver allografts, in conjunction with donor-specific antibody testing, is warranted.

Original languageEnglish (US)
Pages (from-to)1489-1496
Number of pages8
JournalArchives of Pathology and Laboratory Medicine
Volume130
Issue number10
StatePublished - Oct 2006

Fingerprint

Small Intestine
Allografts
Staining and Labeling
Liver
Biopsy
Endothelium
Antibodies
Veins
Kidney
Negative Staining
Complement Activation
Organ Transplantation
Paraffin
Formaldehyde
Blood Vessels
Immune Sera
Arteries

ASJC Scopus subject areas

  • Pathology and Forensic Medicine
  • Medical Laboratory Technology

Cite this

Troxell, M., Higgins, J. P., & Kambham, N. (2006). Evaluation of C4d staining in liver and small intestine allografts. Archives of Pathology and Laboratory Medicine, 130(10), 1489-1496.

Evaluation of C4d staining in liver and small intestine allografts. / Troxell, Megan; Higgins, John P.; Kambham, Neeraja.

In: Archives of Pathology and Laboratory Medicine, Vol. 130, No. 10, 10.2006, p. 1489-1496.

Research output: Contribution to journalArticle

Troxell, M, Higgins, JP & Kambham, N 2006, 'Evaluation of C4d staining in liver and small intestine allografts', Archives of Pathology and Laboratory Medicine, vol. 130, no. 10, pp. 1489-1496.
Troxell, Megan ; Higgins, John P. ; Kambham, Neeraja. / Evaluation of C4d staining in liver and small intestine allografts. In: Archives of Pathology and Laboratory Medicine. 2006 ; Vol. 130, No. 10. pp. 1489-1496.
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