Histopathology of Human Donor Spleen Utilized as a Desensitization Tool Before Intestinal Transplantation.

American Journal of Clinical Pathology
Sujata GaitondeSuman Setty

Abstract

To describe the histopathologic and immunophenotypic features of a temporary splenic allograft exposed to massive donor-specific antibody (DSA) insult. A human cadaveric donor splenic allograft was temporarily transplanted in a highly sensitized patient with the intention of removing DSA before intestinal transplantation from the same donor. Before splenic transplant, the patient had several preformed cytotoxic DSAs that resulted in positive flow cytometric and complement-dependent cytotoxicity crossmatch. The splenic allograft was removed before intestinal transplantation and evaluated by H&E and immunohistochemical stains. Explanted donor splenic allograft showed several histopathologic changes: expanded red pulp secondary to congestion and marked neutrophilic and macrophage infiltration in the sinusoids, numerous neutrophilic microabscesses, and focal capillaritis. The C4d and IgG immunohistochemical stains were diffusely positive in the endothelial lining of the capillaries and sinusoidal lining, indicating diffuse IgG deposition and complement activation. We propose that the noted changes are features of splenic acute antibody-mediated rejection (AMR). Additional cases are required to determine all the features of splenic ...Continue Reading

References

Apr 3, 1969·The New England Journal of Medicine·R Patel, P I Terasaki
Feb 15, 2001·Pediatric and Developmental Pathology : the Official Journal of the Society for Pediatric Pathology and the Paediatric Pathology Society·K Hansen, D B Singer
Mar 16, 2007·Journal of the American Society of Nephrology : JASN·Robert B Colvin
Jan 10, 2014·American Journal of Transplantation : Official Journal of the American Society of Transplantation and the American Society of Transplant Surgeons·A DjamaliM Samaniego

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Citations

Feb 3, 2021·Current Opinion in Organ Transplantation·Cal S Matsumoto, Sandra Rosen-Bronson

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