Histopathologic changes in anti-angiotensin II type 1 receptor antibody-positive kidney transplant recipients with acute rejection and no donor specific HLA antibodies

Mary Ann Lim, Matthew Palmer, Jennifer Trofe-Clark, Roy D. Bloom, Annette Jackson, Mary Carmelle Philogene, Malek Kamoun

Research output: Contribution to journalArticle

Abstract

Objective To determine the association of antibodies against angiotensin II type 1 receptor (AT1R Ab) and histopathologic changes seen in patients with kidney allograft rejection and negative donor specific HLA antibodies (DSA). Methods Stored sera from 27 patients who had biopsy-proven rejection in the absence of DSA were tested for AT1R Ab. Biopsy slides of all patients were re-examined and classified according to Banff 2013 criteria. Histopathologic changes were compared between AT1R positive and negative patients. Results 75% of patients with positive pre-transplant AT1R Ab had antibody mediated rejection (AMR) compared to 37% of AT1R Ab-negative patients. A trend towards increased interstitial inflammation was observed in the AT1R Ab positive group (p = 0.08). More patients in the AT1R Ab positive group had microcirculation inflammation (88% vs 58% with glomerulitis scores ≥1; 75% vs 58% with peritubular capillaritis scores ≥1). Conclusion In kidney transplant recipients with rejection and no DSA, a higher incidence of AMR and worse inflammation scores are observed in the presence of positive pre-transplant AT1R antibodies.

Original languageEnglish (US)
Pages (from-to)350-356
Number of pages7
JournalHuman Immunology
Volume78
Issue number4
DOIs
StatePublished - Apr 1 2017

Keywords

  • Anti-angiotensin II
  • Antibody
  • Kidney transplant
  • Non-HLA
  • Rejection

ASJC Scopus subject areas

  • Immunology and Allergy
  • Immunology

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