{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,1]],"date-time":"2026-09-01T03:37:19Z","timestamp":1788233839528,"version":"build-2803163510"},"reference-count":21,"publisher":"Wiley","issue":"4","license":[{"start":{"date-parts":[[2021,2,16]],"date-time":"2021-02-16T00:00:00Z","timestamp":1613433600000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Clinical Transplantation"],"published-print":{"date-parts":[[2021,4]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Background<\/jats:title><jats:p>Capillary deposition of C4d is an important marker of antibody\u2010mediated rejection (AMR) following heart transplantation (HT). There are two immunopathologic assay methods for detecting C4d: frozen\u2010tissue immunofluorescence (IF) and paraffin immunohistochemistry (IHC). The clinical significance of discrepancy between the results of IF and IHC has not been understood.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods and results<\/jats:title><jats:p>We reviewed 2187 biopsies from 142 HT recipients who had biopsies with assessment of both IF and IHC staining. Among them, 103 (73%) patients had negative IF and IHC C4d staining (Negative Group) and 32 (23%) patients had positive IF but negative IHC staining (Discordant Group). At the time of positive biopsy, 6 (19%) Discordant patients had graft dysfunction, compared to 5 (5%) Negative patients (<jats:italic>p<\/jats:italic>\u00a0=\u00a0.022). Cumulative incidence of cellular rejection at 1\u00a0year was comparable (31% vs. 29%, <jats:italic>p<\/jats:italic>\u00a0=\u00a0.46); however, cumulative incidence of AMR was significantly higher in the Discordant group (21% vs. 4%, <jats:italic>p<\/jats:italic>\u00a0=\u00a0.004). Overall 1\u2010year survival was comparable (90% vs. 96%, <jats:italic>p<\/jats:italic>\u00a0=\u00a0.24); however, freedom from heart failure (HF) was significantly lower in the Discordant group (70% vs. 96%, <jats:italic>p<\/jats:italic>\u00a0&lt;\u00a0.001).<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusion<\/jats:title><jats:p>The Discordant group showed higher rates of graft dysfunction, AMR and HF admission than the Negative group.<\/jats:p><\/jats:sec>","DOI":"10.1111\/ctr.14242","type":"journal-article","created":{"date-parts":[[2021,2,6]],"date-time":"2021-02-06T05:48:43Z","timestamp":1612590523000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":6,"title":["Discordance between immunofluorescence and immunohistochemistry C4d staining and outcomes following heart transplantation"],"prefix":"10.1111","volume":"35","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-2886-3479","authenticated-orcid":false,"given":"Takeo","family":"Fujino","sequence":"first","affiliation":[{"name":"Department of Medicine University of Chicago Medical Center Chicago IL USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yuto","family":"Kumai","sequence":"additional","affiliation":[{"name":"Cardiology Division Columbia University New York NY USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Benjamin","family":"Yang","sequence":"additional","affiliation":[{"name":"Department of Medicine University of Chicago Medical Center Chicago IL USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sara","family":"Kalantari","sequence":"additional","affiliation":[{"name":"Department of Medicine University of Chicago Medical Center Chicago IL USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Daniel","family":"Rodgers","sequence":"additional","affiliation":[{"name":"Department of Medicine University of Chicago Medical Center Chicago IL USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kammi","family":"Henriksen","sequence":"additional","affiliation":[{"name":"Department of Pathology University of Chicago Medical Center Chicago IL USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Anthony","family":"Chang","sequence":"additional","affiliation":[{"name":"Department of Pathology University of Chicago Medical Center Chicago IL USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Aliya","family":"Husain","sequence":"additional","affiliation":[{"name":"Department of Pathology University of Chicago Medical Center Chicago IL 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