CLQ Dominant Deposits in Renal Transplant Biopsies Are Not Associated with Allograft Dysfunction
Babu A, Williamson S, Khoury N, Safwan M, and Patel A. CLQ Dominant Deposits in Renal Transplant Biopsies Are Not Associated with Allograft Dysfunction. Am J Transplant 2019; 19:892.
Am J Transplant
Purpose: Complement deposition in renal allograft biopsies and native kidneys may represent an ongoing inflammatory process. We studied the significance of incidental finding of predominant Clq deposits in the renal allograft biopsies on renal function, proteinuria, and graft survival. Methods: Retrospectively, patients who have undergone renal biopsies either proto-col or for cause were retrieved for the last five years. Eight patients were found to have dominant or codominant Clq deposits. Patients without Clq deposits (n=21) were selected from the same time period as a control group. Demographic data, creatinine, proteinuria, graft survival data were collected from the electronic medical records: Results: Our analysis included 8 cases with predominant Clq deposits and 21 controls without Clq deposits. Cause of end stage renal disease included type 2 diabetes in 4 cases, type 1 diabetes 1 case, 2 cases had chronic GN, 1 case APRT enzyme deficiency. There were no differences in age, duration on dialysis, HLA mismatch. or induction/maintenance immunosuppressive agents. At one year follow up there was no difference in creatinine or incidence of proteinuria. There were no graft loss in the cases. Potentially deceptive pathologic findings included kappa light chain predominance in deposits of 1 case (without glomerular morphologic alterations) and tubuloreticular structures by electron microscopy in another (without clinical evidence of lupus). Conclusions: In this well-characterized cohort of patients with dominant Clq deposits in the mesangium, there was no association with renal allograft dysfunction or proteinuria. In this short follow up there was no effect on allograft survival. We conclude that there is no clinical relevance of isolated predominant Clq deposit in short-term follow-up. This is in line with one other published study. Further studies are needed to look for long-term effects of Clq deposits and if these lesions persist or disappear in subsequent biopsies.