C4d Recomendations C4d staining should be done on all diagnostic renal transplant biopsies.

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Presentation transcript:

C4d Recomendations C4d staining should be done on all diagnostic renal transplant biopsies.

Criteria for C4d Positivity 1. Cryostat section, Monoclonal Ab, immunofluorescence. Widespread, strong, linear, circumferential, peritubular capillary staining in either cortex or medulla Excluding scarred or necrotic areas Concurrent positive control (essential, if neg being reported) Reports should include the % of area of positive PTC and intensity.

Criteria for C4d Positivity 2. Paraffin, Polyclonal Ab, immunohistochemistry Same as frozen tissue, but strong staining not required* *The type of pretreatment influences the intensity. GBM/mesangial staining in the sample cannot be used as a positive control, but membranous GN is satisfactory.