SP711THE PROGNOSTIC SIGNIFICANCE OF CD3+, CD68+, CD20+ INTERSTITIAL CELLS IN PATIENTS WITH KIDNEY ALLOGRAFT GLOMERULITIS

Le résumé fourni par la source

INTRODUCTION: Glomerulitis is independently associated with increased risk of graft failure. Endocapillary glomerular inflammation is frequently accompanied by interstitial infiltration by different types of immune cells. The aim of the study was to test the hypothesis on possible association between the counts of interstitial CD3+, CD68+ and CD20+ cells and long-term prognosis of kidney allograft (KA) with glomerulitis. METHODS: Eighty six KA recipients with glomerulitis according to the Banff 2013-2017 criteria were enrolled in the retrospective study. According donor-specific antibodies (DSA) status patients were further subdivided into the following groups: with negative DSA (n=53); with positive DSA (n=22); with undetermined DSA (n=11). Quantitative immunohistochemical count of interstitial CD68+, CD3+, CD20+ cells was performed. The relationship between interstitial CD3+, CD68+, CD20+ cells count and risk of KA loss was analyzed by Kaplan-Meier survival and Cox proportional hazards regression. The median follow-up was 54 (12; 77) months. RESULTS: CD68+ and CD3+ cells prevailed in interstitium in KA glomerulitis. CD20+ infiltrates were found in 60% of cases. CD20+ cells tended to form infiltrates, in 9 cases these infiltrates reached large sizes (≥ 50 CD20+ lymphocytes) and formed nodular structures. There was no difference in the count of interstitial CD3+ and CD68+ cells and in the presence of CD20+ infiltrates between DSA subgroups. Interstitial CD68+ ≥ 5 cells per field of view (FOV) (x400) and CD3+ ≥ 8 cells per FOV (x400), as well as the presence of large CD20+ infiltrates were associated with a lower KA survival (Figure). In the adjusted multivariable Cox regression analysis interstitial CD68+ ≥ 5 cells/FOV (Exp(B):3,361, 95% CI: 1,031-11,147), CD3 + ≥ 8 cells/FOV (Exp(B):7,958, 95% CI: 1,077-58,814) and the presence of large CD20+ interstitial infiltrates (Exp(B): 3,637, 95% CI: 1,355-9,762) were independently associated with the risk of KA loss. CONCLUSIONS: Grade of interstitial infiltration by CD68+, CD3+ and CD20+ cells in KA glomerulitis could be independent predictor of KA loss.

Ce résumé expose les affirmations des auteurs. BNTIC ne l’interprète pas comme une validation indépendante des résultats.