Korean J Transplant 2022; 36(3): 180-186
Published online September 30, 2022
https://doi.org/10.4285/kjt.22.0032
© The Korean Society for Transplantation
Eun-Ah Jo1 , Hyo Kee Kim1,2
, Sangil Min1
, Kyung Chul Moon3
, Ahram Han1
, Sanghyun Ahn1
, Seung-Kee Min1
, Jongwon Ha1
1Department of Surgery, Seoul National University College of Medicine, Seoul, Korea
2Department of Surgery, Korea University Guro Hospital, Seoul, Korea
3Department of Pathology, Seoul National University College of Medicine, Seoul, Korea
Correspondence to: Sangil Min
Department of Surgery, Seoul National University College of Medicine, 103 Daehak-ro, Jongno-gu, Seoul 03080, Korea
Tel: +82-2-2072-2330
Fax: +82-2-766-3975
E-mail: surgeonmsi@gmail.com
This is an Open Access article distributed under the terms of the Creative Commons Attribution Non-Commercial License (http://creativecommons.org/licenses/by-nc/4.0/) which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited.
Background: C1q nephropathy is an uncommon type of glomerulonephritis characterized by extensive and dominant C1q mesangial deposition in the absence of systemic lupus erythematosus. However, there are limited studies about C1q deposition in renal allografts. This study aimed to report the prevalence of C1q deposition in transplanted kidney allograft biopsies and describe its clinical and histopathologic features.
Methods: Between January 2005 and December 2018, a total of 1,742 kidney transplantations were performed at Seoul National University Hospital. All renal allograft biopsies (n=10,217) of these patients were retrospectively screened for C1q deposition. C1q deposition was detected in the renal allograft biopsies of 104 patients (6.0%). Only 28 cases (1.6%) had intense (≥2+) C1q dominance and were reviewed in this study.
Results: Among the 28 cases, only four (14.3%) had accompanying proliferative glomerulonephritis. Most did not have any other glomerular changes on light microscopy. No patients had nephrotic-range proteinuria at the time of biopsy. A follow-up biopsy was undertaken in 15 of the cases (53.6%). In these follow-up biopsies, C1q deposition either completely disappeared (n=13, 86.7%) or showed diminished staining (n=2, 13.3%).
Conclusions: The prevalence of dominant or codominant C1q deposition in transplanted renal allograft biopsies was 1.6%. Most cases did not have any other accompanying glomerular changes. The follow-up biopsies of these allografts showed spontaneous disappearance or diminished staining of C1q deposition. These findings suggest that C1q deposition found in renal allografts is most likely clinically benign, although this possibility should be confirmed in further large-scale studies.
Keywords: Kidney transplantation, Biopsy, Allografts, C1q complement
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