Background: Differential diagnosis of Membranoproliferative Glomerulonephritis (MPGN) in renal allograft was difficult because of the confused etiology. Recurrent or de novo MPGN were related to the immunoglobulin-mediated or complement-mediated injury according to the deposition of material in the glomerular. However, the character of etiology of MPGN pattern without immunoglobulin(Ig) and complement in renal allograft was never reported before. This study was to explore the character and etiology of this special kind of MPGN pattern in renal allograft. Methodology: Total 37 receipts were separated into MPGN group (deposition with Ig or complement,n=11), MPGN pattern group(without Ig and complement, n=11) and transplant glomerulopathy group(TG)(n=15). The clinical data were compared in three groups, and histological changes according to Banff criterion were compared in three groups. These markers of humoral rejection(C4d deposition in PTC, T bet ) were compared among three groups. Result: MPGN group and MPGN pattern group have heavy proteinuria compared with TG group (3.9 vs 3.9 vs 2.0, P<0.05). The C3 level in MPGN group was lower than MPGN pattern and TG group (0.7 vs 1.1 vs 1.2, P<0.01), the same as ratio of DSA( 2/11 vs 8/11 vs 13/15, P <0.05). The histological changes among three groups show that the mesangial proliferation in MPGN group and MPGN pattern group was more serious than TG group(2.5 vs 2.46 vs 1.8 P<0.01). The glomerulitis was similar in three groups(2.3 vs 2.4 vs 2.1 P=0.14). The peritubular capillary inflammation in MPGN pattern group and TG group were higher than MPGN group(2.1 vs 2.3 vs 0.6, P<0.05) and similar to C4d score(2.3 vs 2.2 vs 0.8, P<0.05) . The positive of T-bet in MPGN pattern group and TG group were higher than MPGN group(9/11 vs 13/15 vs 2/11 P<0.01). The electron-dense material deposited in subendothelial or epithelial side in MPGN group was more popular than MPGN pattern group and TG group(10/11 vs 1/11 vs 1/15 P<0.01). Conclusion: Although the light microscopyand protein were similar between MPGN group and MPGN pattern group. The peritubular capillary inflammation, C4d score, DSA ratio, and T-bet expression were similar in MPGN pattern group and TG group, which disclosed that MPGN pattern without Ig and complement deposition in renal allograft was related to the injury of antibody-mediated rejection.

CITATION INFORMATION: Wen J, Xu F, Chen J, Li X, Zhang M, Zhang Z, Liu Z. Membranoproliferative Glomerulonephritis Pattern without Immunoglobulin and Complement Deposition in Renal Allograft Was Related to the Injury of Antibody-Mediated Rejection. Am J Transplant. 2016;16 (suppl 3).

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