Free Airway C4d after Lung Transplantation - A Quantitative Analysis of Bronchoalveolar Lavage Fluid

In recent years, the utility of vascular complement factor 4d (C4d) deposition as diagnostic tool for antibody mediated rejection (AMR) after lung transplantation, has become a controversial issue. We aimed to pinpoint the problematic nature of C4d as biomarker with a simple experiment. We quantifie...

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Bibliographic Details
Published in:Transplant immunology 2021-02, Vol.64, p.101352-101352, Article 101352
Main Authors: Heigl, Tobias, Saez-Gimenez, Berta, Van Herck, Anke, Kaes, Janne, Sacreas, Annelore, Beeckmans, Hanne, Ambrocio, Gene P.L., Kwakkel-Van Erp, Hanneke, Ordies, Sofie, Vanstapel, Arno, Verleden, Stijn E., Neyrinck, Arne P., Ceulemans, Laurens J., Van Raemdonck, Dirk E., Verbeken, Erik, Verleden, Geert M., Vos, Robin, Vanaudenaerde, Bart
Format: Article
Language:English
Subjects:
Adult
Allografts - immunology
Antibody mediated rejection
Biomarkers - metabolism
Broncho-alveolar lavage
Bronchoalveolar Lavage Fluid - chemistry
C-Reactive Protein - metabolism
Chronic Disease
Chronic lung allograft dysfunction
Complement C4b - metabolism
Complement factor C4d
Diagnosis, Differential
Female
Graft Rejection - immunology
HLA Antigens - immunology
Humans
Isoantibodies - metabolism
Lung Transplantation
Male
Middle Aged
Peptide Fragments - metabolism
Respiratory System - metabolism
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Summary:In recent years, the utility of vascular complement factor 4d (C4d) deposition as diagnostic tool for antibody mediated rejection (AMR) after lung transplantation, has become a controversial issue. We aimed to pinpoint the problematic nature of C4d as biomarker with a simple experiment. We quantified C4d in broncho-alveolar lavage (BAL) of lung transplant patients with diverse post-transplant complications in 3 different settings of clinically clear cases of: 1/ chronic lung allograft dysfunction (CLAD); 2/ acute complications acute rejection (AR), lymphocytic bronchiolitis (LB), antibody-mediated rejection (AMR) and respiratory infection (INF); 3/ patients with parallel C4d immunostaining and Anti-HLA. All groups were compared to BAL of stable patients. C4d was measured via standard ELISA. C4d was increased in CLAD, predominantly in RAS (p = 0.0026) but not in BOS (p = 0.89). C4d was increased in all acute events, AR (p = 0.0025), LB (p 
ISSN:0966-3274
1878-5492
DOI:10.1016/j.trim.2020.101352