Table 4.

Clinical data and follow-up on 24 patients with C4d-positive stain on biopsya

CaseTime Post-transplantation (mo)Age at Biopsy (yr)SCr at Biopsy (mg/dl)Banff GradeTreatmentSCr 1 Mo after BiopsyFollow-Up SCr (mg/dl)Follow-Up Time (mo)
O-23b12370.8SNERNo acute treatment0.8c0.812
O-70.25393.7NERNo acute treatment1.3c1.529
O-100.25411.3SNERNo acute treatment1.0c1.015
O-290.25494.7SNERdNo acute treatment1.0c1.47
S-A7581.0BordNo acute treatment1.1c1.221
O-2278283.2NERChange to rapamycin, increase Cellcept3.13.211
O-16156723.2NERNo acute treatment3.4Dialysis5
S-Fb96603.4NERNo acute treatmentDialysisDialysis1
O-120.3112.1BordIV steroids0.8c0.723
S-C120131.34BordIV steroids0.940.917
O-536323.5IaIV steroids1.6c1.729
S-H36203.8IaIV steroids and increased rapamycin2.735.46
O-3584292.3IaIV steroids and increased Imuran2.32.22
O-2512181.8IaIV steroids1.95.0N11
O-3619192.7IbIV steroids35.0N4
O-181085212BordIV steroids and dialysisDialysisDialysis1
S-B120131.17IaThymoglobulin and IV steroids0.950.918
S-Ib120130.97IbThymoglobulin0.880.920
O-60.25662.8NERIVIg, rituximab, plasmapheresis1.20.913
S-E0.75268.3IIaThymoglobulin1.3c1.033
S-Db36111.3IbThymoglobulin, IV steroids, increase Prograf1.081.112
O-27b32402.1IIaThymoglobulin1.4–1.81.82
O-80.25642.2NERIVIg, rituximab, plasmapheresis, IV steroids2.0c2.915
S-G36203.2BordThymoglobulin, IV steroids2.135.45
  • a Includes Stanford (S-) and OHSU (O-) data sets. Clinical data and follow-up not available for two C4d-positive cases. Bord, Borderline per Banff criteria; IV, intravenous; N, patient noncompliance resulting in graft loss; NER, no evidence of rejection; S, surveillance biopsy; SCr, serum creatinine.

  • b Discordant IHC/IF immunostaining results.

  • c Returns to within 20% of baseline SCr.

  • d Inadequate by Banff criteria.