Measurement of Human Erythrocyte C4d to Erythrocyte Complement Receptor 1 Ratio in Cardiac Transplant Recipients With Acute Symptomatic Allograft Failure

K. C. Lee, C. Y. Chang, Y. C. Chuang, S. H. Sue, T. W. Chu, R. J. Chen, S. H. Chen, J. Wei, C. H. Chen

Research output: Contribution to journalArticle

5 Citations (Scopus)

Abstract

Background: Complement activation has been recognized as a contributing factor to cardiac allograft dysfunction. Combined measurement of erythrocyte C4d (E-C4d) and complement receptor 1 (E-CR1) are potential biomarkers to monitor complement activity in patients with autoimmune diseases. We conducted a prospective study using CR1-2B11 monoclonal antibody to detect the E-C4d to E-CR1 ratio among our cardiac transplant recipients with acute symptomatic allograft failure. Materials and methods: Eight recipients with acute cardiac allograft failure and 72 healthy controls were included in this study. Levels of E-C4d and E-CR1 were measured by indirect immunofluorescence and flow cytometry. The results were utilized to determine the association between patient C4d staining, histological features, and clinical outcomes. Results: Eight patients with nine episodes of sudden onset of graft failure and suspected antibody-mediated rejection (AMR) were included in this study. One patient who received emergent mechanical circulatory support was treated with plasmapheresis for his unstable hemodynamic status. The mean pretreatment left ventricular ejection fraction was 30.3%. No histological study demonstrated cellular rejection or AMR in any patient. There were two patients with positive C4d immunostaining. Three patients had four episodes of acute rejection with sudden death at home. The mean E-C4d/E-CR1 ratio in the study group (n = 9) was 0.22 ± 0.07, and 0.12 ± 0.10 in the control group (n = 72). As comparing both groups, we found the ratios were significant higher in the study group (P = .0003). Conclusions: Measurement of the E-C4d/E-CR1 ratio may be a noninvasive method for detecting acute rejection after cardiac transplantation.

Original languageEnglish
Pages (from-to)2638-2642
Number of pages5
JournalTransplantation Proceedings
Volume40
Issue number8
DOIs
Publication statusPublished - Oct 1 2008
Externally publishedYes

Fingerprint

Complement C1
Complement Receptors
Allografts
Erythrocytes
Plasmapheresis
Antibodies
Complement Activation
Heart Transplantation
Indirect Fluorescent Antibody Technique
Sudden Death
Transplant Recipients
Stroke Volume
Autoimmune Diseases
Flow Cytometry
Heart Failure
Biomarkers
Hemodynamics
Monoclonal Antibodies
Prospective Studies
Staining and Labeling

ASJC Scopus subject areas

  • Surgery
  • Transplantation

Cite this

Measurement of Human Erythrocyte C4d to Erythrocyte Complement Receptor 1 Ratio in Cardiac Transplant Recipients With Acute Symptomatic Allograft Failure. / Lee, K. C.; Chang, C. Y.; Chuang, Y. C.; Sue, S. H.; Chu, T. W.; Chen, R. J.; Chen, S. H.; Wei, J.; Chen, C. H.

In: Transplantation Proceedings, Vol. 40, No. 8, 01.10.2008, p. 2638-2642.

Research output: Contribution to journalArticle

Lee, K. C. ; Chang, C. Y. ; Chuang, Y. C. ; Sue, S. H. ; Chu, T. W. ; Chen, R. J. ; Chen, S. H. ; Wei, J. ; Chen, C. H. / Measurement of Human Erythrocyte C4d to Erythrocyte Complement Receptor 1 Ratio in Cardiac Transplant Recipients With Acute Symptomatic Allograft Failure. In: Transplantation Proceedings. 2008 ; Vol. 40, No. 8. pp. 2638-2642.
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abstract = "Background: Complement activation has been recognized as a contributing factor to cardiac allograft dysfunction. Combined measurement of erythrocyte C4d (E-C4d) and complement receptor 1 (E-CR1) are potential biomarkers to monitor complement activity in patients with autoimmune diseases. We conducted a prospective study using CR1-2B11 monoclonal antibody to detect the E-C4d to E-CR1 ratio among our cardiac transplant recipients with acute symptomatic allograft failure. Materials and methods: Eight recipients with acute cardiac allograft failure and 72 healthy controls were included in this study. Levels of E-C4d and E-CR1 were measured by indirect immunofluorescence and flow cytometry. The results were utilized to determine the association between patient C4d staining, histological features, and clinical outcomes. Results: Eight patients with nine episodes of sudden onset of graft failure and suspected antibody-mediated rejection (AMR) were included in this study. One patient who received emergent mechanical circulatory support was treated with plasmapheresis for his unstable hemodynamic status. The mean pretreatment left ventricular ejection fraction was 30.3{\%}. No histological study demonstrated cellular rejection or AMR in any patient. There were two patients with positive C4d immunostaining. Three patients had four episodes of acute rejection with sudden death at home. The mean E-C4d/E-CR1 ratio in the study group (n = 9) was 0.22 ± 0.07, and 0.12 ± 0.10 in the control group (n = 72). As comparing both groups, we found the ratios were significant higher in the study group (P = .0003). Conclusions: Measurement of the E-C4d/E-CR1 ratio may be a noninvasive method for detecting acute rejection after cardiac transplantation.",
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T1 - Measurement of Human Erythrocyte C4d to Erythrocyte Complement Receptor 1 Ratio in Cardiac Transplant Recipients With Acute Symptomatic Allograft Failure

AU - Lee, K. C.

AU - Chang, C. Y.

AU - Chuang, Y. C.

AU - Sue, S. H.

AU - Chu, T. W.

AU - Chen, R. J.

AU - Chen, S. H.

AU - Wei, J.

AU - Chen, C. H.

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Y1 - 2008/10/1

N2 - Background: Complement activation has been recognized as a contributing factor to cardiac allograft dysfunction. Combined measurement of erythrocyte C4d (E-C4d) and complement receptor 1 (E-CR1) are potential biomarkers to monitor complement activity in patients with autoimmune diseases. We conducted a prospective study using CR1-2B11 monoclonal antibody to detect the E-C4d to E-CR1 ratio among our cardiac transplant recipients with acute symptomatic allograft failure. Materials and methods: Eight recipients with acute cardiac allograft failure and 72 healthy controls were included in this study. Levels of E-C4d and E-CR1 were measured by indirect immunofluorescence and flow cytometry. The results were utilized to determine the association between patient C4d staining, histological features, and clinical outcomes. Results: Eight patients with nine episodes of sudden onset of graft failure and suspected antibody-mediated rejection (AMR) were included in this study. One patient who received emergent mechanical circulatory support was treated with plasmapheresis for his unstable hemodynamic status. The mean pretreatment left ventricular ejection fraction was 30.3%. No histological study demonstrated cellular rejection or AMR in any patient. There were two patients with positive C4d immunostaining. Three patients had four episodes of acute rejection with sudden death at home. The mean E-C4d/E-CR1 ratio in the study group (n = 9) was 0.22 ± 0.07, and 0.12 ± 0.10 in the control group (n = 72). As comparing both groups, we found the ratios were significant higher in the study group (P = .0003). Conclusions: Measurement of the E-C4d/E-CR1 ratio may be a noninvasive method for detecting acute rejection after cardiac transplantation.

AB - Background: Complement activation has been recognized as a contributing factor to cardiac allograft dysfunction. Combined measurement of erythrocyte C4d (E-C4d) and complement receptor 1 (E-CR1) are potential biomarkers to monitor complement activity in patients with autoimmune diseases. We conducted a prospective study using CR1-2B11 monoclonal antibody to detect the E-C4d to E-CR1 ratio among our cardiac transplant recipients with acute symptomatic allograft failure. Materials and methods: Eight recipients with acute cardiac allograft failure and 72 healthy controls were included in this study. Levels of E-C4d and E-CR1 were measured by indirect immunofluorescence and flow cytometry. The results were utilized to determine the association between patient C4d staining, histological features, and clinical outcomes. Results: Eight patients with nine episodes of sudden onset of graft failure and suspected antibody-mediated rejection (AMR) were included in this study. One patient who received emergent mechanical circulatory support was treated with plasmapheresis for his unstable hemodynamic status. The mean pretreatment left ventricular ejection fraction was 30.3%. No histological study demonstrated cellular rejection or AMR in any patient. There were two patients with positive C4d immunostaining. Three patients had four episodes of acute rejection with sudden death at home. The mean E-C4d/E-CR1 ratio in the study group (n = 9) was 0.22 ± 0.07, and 0.12 ± 0.10 in the control group (n = 72). As comparing both groups, we found the ratios were significant higher in the study group (P = .0003). Conclusions: Measurement of the E-C4d/E-CR1 ratio may be a noninvasive method for detecting acute rejection after cardiac transplantation.

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