COMMENTARY

Should C4d Be Used as a Marker in Pancreas Transplant Biopsies?

Ron Shapiro, MD

Disclosures

August 30, 2010

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Hi, my name is Ron Shapiro. I'm a transplant surgeon at the University of Pittsburgh, and today I want to talk to you about rejection in pancreas transplant recipients.

We all know that C4d staining has been important in the diagnosis of antibody-mediated rejection in kidney transplant patients. But there have been fewer data with regard to nonrenal transplant recipients. The analysis from both Leiden [The Netherlands] and the University of Maryland suggest that, not surprisingly, both donor-specific and C4d staining were important negative prognostic factors in patients with pancreas allograft projection after pancreas transplantation.[1]

The importance of this report, I believe, lies in the generalizability of C4d as a bad actor in patients undergoing all sorts of solid organ transplant procedures. It is interesting to see that it holds true in the pancreas recipients as well as in the kidney recipients. Thank you.

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