Clinical impacts of CD38+ B cells on acute cellular rejection with CD20+ B cells in renal allograft

Transplantation. 2010 Jun 27;89(12):1489-95. doi: 10.1097/TP.0b013e3181dd35b8.


Background: There is an increasing evidence that the presence of CD20 B cells is associated with poor clinical outcomes in acute cellular rejection (ACR), but clinical significance of CD38 B cells is undetermined. We attempted to examine the clinical significance of the CD38 B cells alone or in combination with CD20 B cells in renal transplant recipients with ACR.

Methods: Fifty-four patients with ACR were included. Biopsy specimens were stained for CD20 and CD38. The clinical outcomes of CD20 or CD38 B cells were evaluated with late-onset and repeated ACR, steroid resistance, incomplete recovery after rejection treatment, and allograft survival.

Results: Twenty-three patients (42.6%) had CD20 and 25 (46.3%) patients had CD38 B cells. Of these, 15 patients (27.8%) were positive for both CD20 and CD38 (CD20CD38). CD38 patients had higher rates of late-onset or repeated ACR and incomplete recovery compared with CD38 patients (P<0.05). The patients with CD20CD38 had a higher incomplete recovery rate than did patients with only CD20 or CD38 (P<0.05). The 5-year allograft survival was lower in CD20 and CD38 patients than in CD20 or CD38 patients (P<0.05 for each). CD20CD38 patients had lower graft survival than did patients with CD20 or CD38 alone (P<0.05).

Conclusion: Infiltration of CD38 B cells alone or in combination with CD20 B cells is a predictor for poor clinical outcomes of ACR in renal allograft.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • ADP-ribosyl Cyclase 1 / biosynthesis*
  • Adult
  • Age of Onset
  • Antigens, CD20 / biosynthesis*
  • B-Lymphocytes / immunology*
  • B-Lymphocytes / metabolism
  • Biopsy
  • Female
  • Graft Rejection
  • Graft Survival
  • Humans
  • Immunosuppressive Agents / therapeutic use
  • Kidney Transplantation / methods*
  • Male
  • Middle Aged
  • Renal Insufficiency / blood*
  • Renal Insufficiency / therapy*
  • Treatment Outcome


  • Antigens, CD20
  • Immunosuppressive Agents
  • ADP-ribosyl Cyclase 1