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Endothelial gene expression in kidney transplants with alloantibody indicates antibody-mediated damage despite lack of C4d staining
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NK cell transcripts and NK cells in kidney biopsies from patients with donor-specific antibodies: Evidence for NK cell involvement in antibody-mediated rejection
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A study of 145 renal allograft biopsies done for cause, in which microarray analysis was used to identify a set of 23 DSA-specific gene transcripts. Seven of these transcripts show high expression in NK cells, and the authors also used immuno-histochemistry to demonstrate prominent numbers of NK cells within peritubular capillaries in biopsies with antibody-mediated, but not cell-mediated, rejection
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Hidalgo LG, Sis B, Sellares J, et al. NK cell transcripts and NK cells in kidney biopsies from patients with donor-specific antibodies: evidence for NK cell involvement in antibody-mediated rejection. Am J Transplant 2010; 10:1812-1822. A study of 145 renal allograft biopsies done for cause, in which microarray analysis was used to identify a set of 23 DSA-specific gene transcripts. Seven of these transcripts show high expression in NK cells, and the authors also used immuno-histochemistry to demonstrate prominent numbers of NK cells within peritubular capillaries in biopsies with antibody-mediated, but not cell-mediated, rejection.
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Hidalgo, L.G.1
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A study of 98 early (<3 months after transplantation), for cause renal allograft biopsies that were examined by electron microscopy. Fifty to 60% of the biopsies with C4d-positive or C4d-negative AMR showed each of three early changes of endothelial injury in glomeruli by electron microscopy, compared with 0% of biopsies showing CMR or no rejection. Among 18 DSA-positive patients showing these early changes, progression to overt transplant glomerulopathy was seen in two of eight patients who were treated for AMR after the early biopsy and six of eight who were not; seven of the latter eight patients had C4d-negative AMR
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Haas M, Mirocha J. Early ultrastructural changes in renal allografts: correlation with antibody-mediated rejection and transplant glomerulopathy. Am J Transplant 2011; 11:2123-2131. A study of 98 early (<3 months after transplantation), for cause renal allograft biopsies that were examined by electron microscopy. Fifty to 60% of the biopsies with C4d-positive or C4d-negative AMR showed each of three early changes of endothelial injury in glomeruli by electron microscopy, compared with 0% of biopsies showing CMR or no rejection. Among 18 DSA-positive patients showing these early changes, progression to overt transplant glomerulopathy was seen in two of eight patients who were treated for AMR after the early biopsy and six of eight who were not; seven of the latter eight patients had C4d-negative AMR.
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Haas, M.1
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Sund, S.38
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Einecke G, Melk A, Ramassar V, et al. Expression of CTL associated transcripts precedes the development of tubulitis in T cell mediated kidney graft rejection. Am J Transplant 2005; 5:1827-1836. (Pubitemid 41039855)
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Einecke, G.1
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Chris, B.R.5
Famulski, K.S.6
Halloran, P.F.7
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45
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Monocytes/macrophages in kidney allograft intimal arteritis: No association with markers of humoral rejection or with inferior outcome
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Glotz, D.7
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Minervini MI, Torbenson M, Scantlebury V, et al. Acute renal allograft rejection with severe tubulitis (Banff 1997 grade IB). Am J Surg Pathol 2000; 24:553-558. (Pubitemid 30180748)
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Haas M, Kraus ES, Samaniego-Picota M, et al. Acute renal allograft rejection with intimal arteritis: histologic predictors of response to therapy and graft survival. Kidney Int 2002; 61:1516-1526. (Pubitemid 34304514)
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Haas, M.1
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Ni, W.5
Eustace, J.A.6
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50
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Donor-specific antibodies accelerate arteriosclerosis after kidney transplantation
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A study of 3-month and 12-month protocol biopsies of renal allografts in 40 patients with DSAs and 59 without, excluding patients with arteritis. The authors demonstrated a significantly higher rate of progression of arterial intimal fibrosis in the DSA-positive cohort. Furthermore, although the intimal fibrosis in the majority of DSA-positive patients showed a hypercellular zone close to the endothelium, there were DSA-positive patients with a prior history of acute AMR whose biopsies showed bland intimal fibrosis, indistinguishable from banal arteriosclerosis
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Hill GS,Nochy D, Bruneval P, et al. Donor-specific antibodies accelerate arteriosclerosis after kidney transplantation. J Am Soc Nephrol 2011; 22:975-983. A study of 3-month and 12-month protocol biopsies of renal allografts in 40 patients with DSAs and 59 without, excluding patients with arteritis. The authors demonstrated a significantly higher rate of progression of arterial intimal fibrosis in the DSA-positive cohort. Furthermore, although the intimal fibrosis in the majority of DSA-positive patients showed a hypercellular zone close to the endothelium, there were DSA-positive patients with a prior history of acute AMR whose biopsies showed bland intimal fibrosis, indistinguishable from banal arteriosclerosis.
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J Am Soc Nephrol
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Hill, G.S.1
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Colvin, R.B.6
Croker, B.P.7
Droz, D.8
Dunnill, M.S.9
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Jennette, J.C.12
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Marcussen, N.14
Mihatsch, M.J.15
Morozumi, K.16
Myers, B.D.17
Nast, C.C.18
Olsen, S.19
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