Abstract: SA-PO465

The Predictive Value of the Tissue Expression of CD68 in the Occurrence of Antibody Mediated Rejection, Graft Dysfunction, and Loss in Both Standard-Risk and Sensitized Kidney Transplant Recipients

Session Information

Category: Transplantation

  • 1702 Transplantation: Clinical and Translational

Authors

  • Becker, Luis Eduardo, University of Heidelberg, Heidelberg, BW, Germany
  • Nick, Anne-Sophie, University of Heidelberg, Heidelberg, BW, Germany
  • Zeier, Martin G., University of Heidelberg, Heidelberg, BW, Germany
  • Morath, Christian, University of Heidelberg, Heidelberg, BW, Germany
Background

Tissue analysis of intragraft immunological processes remains an essential, but often underestimated tool as an early prognostic determinant of humoral changes and graft loss in kidney transplantation. This is particularly true for the growing population of sensitized recipients with an increased risk of immunological graft loss.

Methods

We retrospectively studied all eligible 213 allograft biopsies from 104 standard-risk and sensitized patients transplanted between 2006 and 2012, obtained in the first year after transplantation. We compared the effect of macrophage infiltration on long-term-allograft function and death-censored graft loss in both risk populations, analyzing the impact on the development of acute and chronic changes.

Results

Organ recipients from deceased donors had a higher CD68-positive cell infiltration one month after transplantation compared to living donor ones. Strong CD68 positivity in the first month after transplantation was associated with the occurrence of delayed graft function in sensitized patients. High number of CD68 positive cells one month after transplantation was a valid predictor of death censored graft loss in standard-risk patients. In sensitized patients, the number of tissue infiltrating CD68-positive cells in biopsies obtained between day 90 and 360 of transplantation was inversely correlated with the kidney function 1, 2 and 3 years after transplantation. Moreover, each CD68-positive cell increased the risk in 1.024 for the further development of antibody mediated rejection in this collective.

Conclusion

Macrophage tissue infiltration represents a potential additional tool for the analysis of kidney transplant biopsies and may predict worse outcomes especially in sensitized patients, irrespective of the histological diagnosis.