Half of our 50 patients with TG documented by EM had no DSAs or positive C4d staining in PTCs. Almost 70% of the patients evidenced PTC basement membrane multilayering. These patients were all diagnosed with chronic active CMR independently of the presence of TG. Cellular rejection mechanisms are likely the cause of the TG in this group. Patients with TG and DSAs are at greater risk for episodes of acute AMR and CMR. C4d staining of PTCs was evident in less than 40% and in the glomeruli in less than half. Interestingly, 25 of the 26 DSA+ patients were independently diagnosed with chronic active CMR.
Recommended CitationVijay-Sharma, MD, Mayuri; Singh, MD, Pooja; Colombe, PhD., Beth W.; Gulati, MD, Rakesh; Faber, MD, John L.; and Francos, MD, George, "Transplant Glomerulopathy in the Absence of Donor Specific Antibodies" (2011). Department of Medicine Faculty Papers. Paper 59.