Immunohistochemical Scoring of C4d in Egyptian Patients with Chronic Renal Allograft Dysfunction

C4d is a degradation product of complement component C4. Since the beginning of the current century, C4d has been used as a marker of acute antibody mediated rejection in renal allograft and considered as an ominous portent for poor graft survival. The ninth Banff meeting emphasized the value of C4d in renal allograft biopsy assessment and adopted a grading system for the staining degree of C4d (0 through 3). The twelfth Banff meeting revised the proposed grading system. The literature data about the role of C4d in chronic renal allograft damage is variable. We conducted a retrospective study for cases with biopsy proven chronic renal allograft damage diagnosed at our nephropathology units, between Jan. 2007 and Sep. 2013 in order to detect and score C4d positive cases comparing the variability between C4d scores in correlation with the available clinical data and histopathological parameters of chronicity. Twenty eight cases (54.9%) were C4d positive. The frequency of cases with scored positive staining was as follows: C4d1 (12 cases, 23.5%), C4d2 (2 cases, 3.9%) and C4d3 (14 cases, 27.5%). No significant clinical or chronic histopathological findings between score (1) and score (3).