CD20-positive infiltrates in renal allograft biopsies with acute cellular rejection are not associated with worse graft survival

Am J Transplant. 2007 Aug;7(8):1968-73. doi: 10.1111/j.1600-6143.2007.01885.x.


We examined rejection outcome and graft survival in 58 adult patients with acute cellular rejection Banff type I (ARI) or II (ARII), within 1 year after transplantation, with or without CD20-positive infiltrates. Antibody-mediated rejection was not examined. Of the 74 allograft biopsies, performed from 1999 to 2001, 40 biopsies showed ARI and 34 biopsies showed ARII; 30% of all the biopsies showed CD20-positive clusters with more than 100 cells, 9% with more than 200 cells and 5% with more than 275 cells. Patients with B cell-rich (>100 or >200/HPF CD20-positive cells) and B cell-poor biopsies (<50 CD20-positive cells/HPF) were compared. Serum creatinine and eGFR of B cell-rich (CD20 > 100/HPF) and B cell-poor were not significantly different at rejection, or at 1, 3, 6 and 12 months, and during additional 3 years follow-up after rejection, although higher creatinine at 1 year was noted in the >200/HPF group. Graft survival was also not different between B cell-rich and B cell-poor groups (p = 0.8 for >100/HPF, p = 0.9 for >200/HPF CD20-positive cells). Our data do not support association of B cell-rich infiltrates in allograft biopsies and worse outcome in acute rejection type I or II, but do not exclude the possible contribution of B cells to allograft rejection.

MeSH terms

  • Acute Disease
  • Adult
  • Aged
  • Antigens, CD20 / immunology*
  • B-Lymphocytes / immunology
  • B-Lymphocytes / pathology
  • Creatinine / blood
  • Enzyme-Linked Immunosorbent Assay
  • Female
  • Follow-Up Studies
  • Glomerular Filtration Rate
  • Graft Rejection / blood
  • Graft Rejection / immunology
  • Graft Rejection / pathology*
  • Graft Survival / immunology*
  • Humans
  • Kidney Transplantation / immunology*
  • Male
  • Middle Aged
  • Prognosis
  • Retrospective Studies
  • Severity of Illness Index
  • Time Factors


  • Antigens, CD20
  • Creatinine