Platelets in early antibody-mediated rejection of renal transplants

Hsiao Hsuan Kuo, Ran Fan, Nina Dvorina, Andres Chiesa-Vottero, William M. Baldwin

Research output: Contribution to journalArticle

Abstract

Antibody-mediated rejection is a major complication in renal transplantation. The pathologic manifestations of acute antibody-mediated rejection that has progressed to functional impairment of a renal transplant have been defined in clinical biopsy specimens. However, the initial stages of the process are difficult to resolve with the unavoidable variables of clinical studies. We devised a model of renal transplantation to elucidate the initial stages of humoral rejection. Kidneys were orthotopically allografted to immunodeficient mice. After perioperative inflammation subsided, donor-specific alloantibodies were passively transferred to the recipient. Within 1 hour after a single transfer of antibodies, C4d was deposited diffusely on capillaries, and von Willebrand factor released from endothelial cells coated intravascular platelet aggregates. Platelet-transported inflammatory mediators platelet factor 4 and serotonin accumulated in the graft at 100- to 1000-fold higher concentrations compared with other platelet-transported chemokines. Activated platelets that expressed P-selectin attached to vascular endothelium and macrophages. These intragraft inflammatory changes were accompanied by evidence of acute endothelial injury. Repeated transfers of alloantibodies over 1 week sustained high levels of platelet factor 4 and serotonin. Platelet depletion decreased platelet mediators and altered the accumulation of macrophages. These data indicate that platelets augment early inflammation in response to donor-specific antibodies and that platelet-derived mediators may be markers of evolving alloantibody responses.

Original languageEnglish (US)
Pages (from-to)855-863
Number of pages9
JournalJournal of the American Society of Nephrology
Volume26
Issue number4
DOIs
StatePublished - Apr 1 2015
Externally publishedYes

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Graft Rejection
Blood Platelets
Kidney
Antibodies
Isoantibodies
Platelet Factor 4
Kidney Transplantation
Serotonin
Macrophages
Inflammation
Transplants
P-Selectin
Vascular Endothelium
von Willebrand Factor
Chemokines
Endothelial Cells
Biopsy
Wounds and Injuries

ASJC Scopus subject areas

  • Nephrology

Cite this

Platelets in early antibody-mediated rejection of renal transplants. / Kuo, Hsiao Hsuan; Fan, Ran; Dvorina, Nina; Chiesa-Vottero, Andres; Baldwin, William M.

In: Journal of the American Society of Nephrology, Vol. 26, No. 4, 01.04.2015, p. 855-863.

Research output: Contribution to journalArticle

Kuo, HH, Fan, R, Dvorina, N, Chiesa-Vottero, A & Baldwin, WM 2015, 'Platelets in early antibody-mediated rejection of renal transplants', Journal of the American Society of Nephrology, vol. 26, no. 4, pp. 855-863. https://doi.org/10.1681/ASN.2013121289
Kuo, Hsiao Hsuan ; Fan, Ran ; Dvorina, Nina ; Chiesa-Vottero, Andres ; Baldwin, William M. / Platelets in early antibody-mediated rejection of renal transplants. In: Journal of the American Society of Nephrology. 2015 ; Vol. 26, No. 4. pp. 855-863.
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