2015年4月2日 · Prophylactic equine ATG has been associated with C4d and horse IgG deposition in capillaries of heart transplant recipients in the absence of clinical AMR. 151 Prophylactic ATG (RATG and equine ATG) has been reported in 1 study to induce acute and hyperacute AMR in nonsensitized patients with renal allografts. 152 Although there have been ...

In the ISHLT consensus report on pulmonary AMR, the number of present criteria increases diagnostic certainty, and the diagnosis of definite AMR is based on the presence of allograft dysfunction, histologic evidence suggestive of AMR, C4d deposition, circulating donor-specific antibodies (DSA), and the reasonable exclusion of other causes .

We review the current diagnostic criteria for AMR; AMR paradigms; and desensitization, treatment, and prevention strategies. Chronic antibody-mediated endothelial injury results in transplant glomerulopathy, manifested as glomerular basement membrane duplication, double contouring, or splitting.

For all ABMR diagnoses, it should be specified in the report whether the lesion is C4d-positive (C4d2 or C4d3 by IF on frozen sections; C4d > 0 by IHC on paraffin sections) or without evident C4d deposition (C4d0 or C4d1 by immunofluorescence (IF) on frozen sections; C4d0 by IHC on paraffin sections).

2022年7月1日 · Our hypothesis that arterial C4d represents AMR was supported by the following: correlations with circulating DSA, histologic C4d ptc, and MVI; colocalization of C4d art with AMR marker using principal component analysis; and biological plausibility.

IHC staining for C4d has been suggested for the diagnosis of AMR. Our data suggest there is a high rate of background C4d staining, but endothelial staining correlates with poorer hemodynamics. Methods for IHC staining and interpretation need to be standardized for widespread use and clinical studie …

2017年6月9日 · Antibody-mediated rejection (AMR) is an increasingly recognized form of lung rejection. C4d deposition has been an inconsistent finding in previous reports and its role in the diagnosis has been controversial.

1993年，Feucht等 发现特异性沉积于肾小管周毛细血管的C4d可用于检测AMR，从而开创了AMR诊断的新标准。 C4d是C4在激活补体的经典途径过程中产生的分裂产物，如今在肾脏和心脏移植中清晰的组织学特征和C4d沉积是公认的诊断AMR的可靠依据 [ 33 ] 。

2022年7月1日 · The diagnosis of late antibody-mediated rejection (AMR) is compromised by frequent absence of C4d in peritubular capillaries (C4d ptc), termed “C4d-negative” AMR. We hypothesized that glomerular capillary C4d (C4d glom ) reflected endothelial interaction with antibody and could improve immunologic classification of transplant glomerulopathy ...

The C4d staining as a special tissue marker for humoral immunity has served criteria of pathological diagnosis for antibody-mediated rejection (ABMR) in Banff classification since 2003. However, the sensitivity and specificity of C4d staining have been questioned, and recently, C4d-negative ABMR has …