Acute humoral rejection (AHR) is difficult to diagnose and portends a poor renal transplant outcome. Donor specific antibody titers (DSA) and staining of allograft biopsies for the complement degradation byproduct C4d have been utilized to establish the presence of AHR. We hypothesize that utilizing both tests would give a higher specificity for AHR, than C4d alone.
Blacksten, Cheri and Morgan Peterson. "Diagnosis of Acute Humoral Rejection by C4d and Donor Specific Antibody Testing." (2009). http://digitalrepository.unm.edu/ume-research-papers/99