ATC Abstracts

American Transplant Congress abstracts

  • Home
  • Meetings Archive
    • 2022 American Transplant Congress
    • 2021 American Transplant Congress
    • 2020 American Transplant Congress
    • 2019 American Transplant Congress
    • 2018 American Transplant Congress
    • 2017 American Transplant Congress
    • 2016 American Transplant Congress
    • 2015 American Transplant Congress
    • 2013 American Transplant Congress
  • Keyword Index
  • Resources
    • 2021 Resources
    • 2016 Resources
      • 2016 Welcome Letter
      • ATC 2016 Program Planning Committees
      • ASTS Council 2015-2016
      • AST Board of Directors 2015-2016
    • 2015 Resources
      • 2015 Welcome Letter
      • ATC 2015 Program Planning Committees
      • ASTS Council 2014-2015
      • AST Board of Directors 2014-2015
      • 2015 Conference Schedule
  • Search

Ultrastructural Changes in Lung Allografts: Endothelial Changes Correlate with Donor Specific Antibody & Antibody Mediated Rejection

M. Alexander, A. Bentall, P. Abell Aleff, J. Scott, A. Roden.

Mayo Clinic, Rochester, MN.

Meeting: 2018 American Transplant Congress

Abstract number: C254

Keywords: Antibodies, Endothelial cells, Lung transplantation, Rejection

Session Information

Session Name: Poster Session C: Lung: All Topics

Session Type: Poster Session

Date: Monday, June 4, 2018

Session Time: 6:00pm-7:00pm

 Presentation Time: 6:00pm-7:00pm

Location: Hall 4EF

Introduction: Antibody mediated rejection (AMR) causes lung allograft (LA) injury. Challenges with C4d interpretation & lack of specific histological criteria account for difficulty in diagnosing pulmonary AMR. DSA target the endothelium. In renal transplant(TX),early ultrastructural (UST) changes of the endothelium correlate with AMR. The aim of this study was to identify UST changes in the endothelium of LA in the presence of DSA, to determine the utility of prospective use of electron microscopy in establishing a diagnosis of AMR in LTx recipients.

Materials & Methods: Cases of pulmonary AMR between 07/2009 & 09/2015 were identified. The ISHLT guidelines were used to categorise them into definite, probable & possible AMR. UST studies were performed on these bxs (fresh or paraffin embedded). Cases of acute cellular rejection (4) & normal lung (3) served as controls. UST findings were correlated with the presence of DSA & diagnosis of AMR using the Pearson's chi-square test.

Results & Discussion: Eleven pts (male, 54.5%) were included in this study (Table 1). Mean age was 53yrs. 3 cases were combined lung & heart TX. We identified 7 cases of AMR (1 definite, 1 probable & 5 possible). The median time from LTx to biopsy (bx) was 210 days (median follow up of 1063 days). UST studies were performed on 10 AMR bxs, 4 ACR bxs & 4 controls (Table2)The presence of DSA & ISHLT diagnosis of AMR correlated with endothelial swelling, cytoplasmic vacuolization & septal edema (p<0.01; each). Septal infiltration by neutrophils was only seen in AMR cases. These differences were still significant in paraffin based EM; although endothelial swelling & vacuolization occurred in non-DSA paraffin samples with EM.

Conclusion:DSA is associated with endothelial injury of the allograft. UST findings such as endothelial swelling & vacuolization help in diagnosing AMR of lung. Although paraffin embedded biopsy material can be used for his purpose, it is not without limitations and larger prospective studies are needed to validate these findings. The effect of DSA on the endothelial pathways will be important in all solid organ transplantation.

CITATION INFORMATION: Alexander M., Bentall A., Abell Aleff P., Scott J., Roden A. Ultrastructural Changes in Lung Allografts: Endothelial Changes Correlate with Donor Specific Antibody & Antibody Mediated Rejection Am J Transplant. 2017;17 (suppl 3).

  • Tweet
  • Click to email a link to a friend (Opens in new window) Email
  • Click to print (Opens in new window) Print

To cite this abstract in AMA style:

Alexander M, Bentall A, Aleff PAbell, Scott J, Roden A. Ultrastructural Changes in Lung Allografts: Endothelial Changes Correlate with Donor Specific Antibody & Antibody Mediated Rejection [abstract]. https://atcmeetingabstracts.com/abstract/ultrastructural-changes-in-lung-allografts-endothelial-changes-correlate-with-donor-specific-antibody-antibody-mediated-rejection/. Accessed June 6, 2025.

« Back to 2018 American Transplant Congress

Visit Our Partner Sites

American Transplant Congress (ATC)

Visit the official site for the American Transplant Congress »

American Journal of Transplantation

The official publication for the American Society of Transplantation (AST) and the American Society of Transplant Surgeons (ASTS) »

American Society of Transplantation (AST)

An organization of more than 3000 professionals dedicated to advancing the field of transplantation. »

American Society of Transplant Surgeons (ASTS)

The society represents approximately 1,800 professionals dedicated to excellence in transplantation surgery. »

Copyright © 2013-2025 by American Society of Transplantation and the American Society of Transplant Surgeons. All rights reserved.

Privacy Policy | Terms of Use | Cookie Preferences