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Predicate | Object |
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rdf:type | |
lifeskim:mentions | |
pubmed:issue |
11
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pubmed:dateCreated |
1996-8-2
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pubmed:abstractText |
Alloantibody frequently appears during the immune response to alloantigens in renal transplant recipients. We studied whether the presence of antibody against donor class I antigens correlated with the clinical and pathologic features of acute rejection episodes. We identified patients who had (1) clinical evidence of acute rejection, (2) a renal biopsy showing pathologic features of acute rejection, defined by the Banff criteria, and (3) pre- and posttransplant sera screened against donor T cells. We divided these patients into those with or without donor-specific alloantibody reactive with donor T cells. Of 44 patients with biopsy-proven rejection, 20 were antibody negative (Ab-R) and 24 were antibody positive (Ab+R). The biopsies from Ab+R patients had a higher incidence of severe vasculitis (P=0.0009) and glomerulitis (P=0.01). Fibrin thrombi in the glomeruli and/or vessels, fibrinoid necrosis, and dilatation of peritubular capillaries were also more frequent in the Ab+R group. Infarction was present in biopsy specimens from 9/24 Ab+R patients versus none in the Ab-R group (P=0.002). The Ab+R biopsy specimens more often had polymorphonuclear leukocytes in the peritubular capillaries (P=0.003). In contrast, specimens of Ab-R patients showed tubulitis more often than the specimens of Ab+R patients: moderate and severe tubulitis was present in 19/20 (95%) Ab-R patients versus 12/24 (50%) Ab+R patients (P=0.002). Graft loss was increased in Ab+R patients, particularly in the first 3 months (12/24 compared with 3/20, P=0.025). Thus, during biopsy-proven acute rejection episodes, anti-class I antibody correlates with severe vascular lesions, glomerulitis, and infarction, whereas more severe tubulitis predominates in rejection episodes without antibody.
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pubmed:language |
eng
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pubmed:journal | |
pubmed:citationSubset |
IM
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pubmed:chemical | |
pubmed:status |
MEDLINE
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pubmed:month |
Jun
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pubmed:issn |
0041-1337
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pubmed:author | |
pubmed:issnType |
Print
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pubmed:day |
15
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pubmed:volume |
61
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pubmed:owner |
NLM
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pubmed:authorsComplete |
Y
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pubmed:pagination |
1586-92
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pubmed:dateRevised |
2004-11-17
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pubmed:meshHeading |
pubmed-meshheading:8669102-Adult,
pubmed-meshheading:8669102-Endothelium, Vascular,
pubmed-meshheading:8669102-Female,
pubmed-meshheading:8669102-Graft Rejection,
pubmed-meshheading:8669102-Histocompatibility Antigens Class I,
pubmed-meshheading:8669102-Humans,
pubmed-meshheading:8669102-Isoantibodies,
pubmed-meshheading:8669102-Kidney,
pubmed-meshheading:8669102-Kidney Transplantation,
pubmed-meshheading:8669102-Male,
pubmed-meshheading:8669102-Middle Aged,
pubmed-meshheading:8669102-Transplantation, Homologous
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pubmed:year |
1996
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pubmed:articleTitle |
Pathologic features of acute renal allograft rejection associated with donor-specific antibody, Analysis using the Banff grading schema.
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pubmed:affiliation |
Department of Laboratory Medicine and Pathology, University of Alberta, Canada.
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pubmed:publicationType |
Journal Article
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