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Background . C3d is a product of both the classic and the alternative complement cascades; however, few studies have addressed the role of C3d in renal biopsies and its relationship with long-term graft survival rate is not very clear.  Methods . 94 patients with biopsy-proven acute rejection episodes were included in the study. We investigated the associations between histological findings, clinical examinations, and outcome.  Results . The overall prevalence for C4dPTC and C3dPTC was 42.6% and 29.8%. There was a significant association between C3dPTC and C4dPTC ( P  < 0.001). C3dPTC and C4dPTC were related with histological types ( P  = 0.024 and  P  < 0.001, resp.). The long-term survival rate for C4dPTC positive transplants was lower than that of C4dPTC negative transplants, but it was not statistic significant in our study ( P  = 0.150). The survival rate of C3dPTC positive group was much lower than the negative group ( P  = 0.014). Patients with double positives for C4dPTC and C3dPTC exhibited the lowest survival rate significantly different from those of the C3dPTC only and C4dPTC only groups ( P  = 0.01 and  P  = 0.0037).  Conclusions . This longitudinal cohort study has demonstrated that C3d deposition in the PTC was closely related to renal dysfunction and pathological changes.

Capillary Deposition of Complement C4d and C3d in Chinese Renal Allograft Biopsies