Journal
AMERICAN JOURNAL OF TRANSPLANTATION
Volume 12, Issue 5, Pages 1180-1191Publisher
WILEY-BLACKWELL
DOI: 10.1111/j.1600-6143.2011.03970.x
Keywords
Antibody-mediated rejection; Banff lesions; C4d; donor specific antibody; HLA antibody; NK cell; renal allograft pathology; renal allograft rejection; transplantation
Categories
Funding
- Genome Canada
- Genome Alberta
- University of Alberta
- University of Alberta Hospital Foundation
- Roche Molecular Systems
- Hoffmann-La Roche Canada Ltd.
- Alberta Ministry of Advanced Education and Technology
- Roche Organ Transplantation Research Foundation
- Kidney Foundation of Canada
- Canadian Institutes of Health Research
- Kidney & Urology Foundation of America - Renal Pathology Society
- Astellas Canada
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NK cell transcripts are increased in biopsies with antibody-mediated rejection, whereas T cell transcripts are increased in T cell-mediated rejection. However, NK and T cells share many features, creating potential ambiguity. Therefore to estimate the NK- versus T cell transcript burdens separately, we defined nonoverlapping transcripts selective for NK cells (N = 4) or T cells (N = 5). We compared NK- versus T cell transcript burdens in microarrays from 403 kidney transplant biopsies (182 early, 221 late). In late biopsies, high NK-cell transcript expression was associated with antibody-mediated rejection, correlating with microvascular inflammation and donor specific HLA antibody. However, some early biopsies with T cell-mediated rejection had high NK-cell transcript expression, as well as T cell transcripts, without evidence of antibody-mediated rejection or DSA, correlating with interstitial inflammation and tubulitis. Both NK-cell and T cell transcripts were moderately increased in many kidneys with inflammation secondary to injury or atrophy scarring. These results support the distinct role of NK cells in late antibody-mediated rejection, but indicate a role for NK-transcript expressing cells (NK cells or T cells with NK features) both in T cell-mediated rejection and in inflammation associated with injury and atrophy scarring.
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