Implication of nonspecific cellular infiltrates in renal transplant patients with chronic allograft nephropathy / 中华器官移植杂志

ABSTRACT

Objective To investigate the implication of nonspecific cellular infiltrates in biopsy of chronic allograft nephropathy and the prognosis.Methods Recipients indicated to renal biopsyproven CAN were analyzed from June 2007 to June 2009 retrospectively,and classified into three groups according to the Banff 2009 criteria:chronic active T-cell-mediated rejection (CTMR),chronic active antibody-mediated rejection (CAMR),interstitial fibrosis and tubular atrophy not otherwise specified (NOS).All the cases were followed up for 2 years.CD4,CD8,CD20 and CD3 expression,and C4d deposits were investigated.Results Eighty-three cases were enrolled in the study,diagnosed as having CTMR in 34 cases (40.9％),CAMR in 12 cases (14.6％),and NOS in 37 cases (44.5％).There was significant difference in total interstitial inflammation (ti),peritubular capillaritis (ptc) and C4d deposition among CTMR,CAMR and NOS groups.The number of CD4+ and CD8+ in CTMR group was increased as compared with CAMR and NOS groups.The 2-yeard renal graft survival in CTMR,NOS and CAMR groups was 73.5％,78.4％ and 41.7％ respectively.The prognosis in CAMR group was worst.Conclusion CAMR predicated a worse graft survival.Infiltration of CD4+ and CD8 + cells may help to make the diagnosis of CTMR.