Association of Kidney Graft Loss with Posttransplant Presence of Strong HLA Antibodies Detected by Luminex Single Antigen Testing

Süsal, Caner; Döhler, Bernd; Ruhenstroth, Andrea; Scherer, Sabine; Tran, Thuong Hien; Morath, C.; Weimer, Rolf; Norman, D. J.; Bösmüller, Claudia; Slavčev, Antonij; Živčić-Ćosić, Stela; Roy, Ronald B.; Opelz, Gerhard

doi:10.1097/00007890-201211271-00113

Cited by 4 publications

(4 citation statements)

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“…Only A, B, and DR MM were considered for DSA. Because no clinically validated cut‐off for the Luminex assay is recommended by the provider company, mean fluorescence intensity (MFI) of ≥500 was used to define the cut‐off for antibody positivity, based on recent data from the CTS serum study that a cut‐off ≥500 MFI gives meaningful results, if de novo antibodies are analyzed .…”

Section: Methodsmentioning

confidence: 99%

Soluble CD30 and ELISA-detected human leukocyte antigen antibodies for the prediction of acute rejection in pediatric renal transplant recipients

et al. 2012

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SummaryBiomarker-based post-transplant immune monitoring for the prediction of impending graft rejection requires validation in specific patient populations. Serum of 28 pediatric renal transplant recipients within the framework of a wellcontrolled prospective randomized trial was analyzed pre-and post-transplant for soluble CD30 (sCD30), a biomarker reflecting mainly T-cell reactivity, and antihuman leukocyte antigen (anti-HLA) antibody reactivity, a biomarker for B-cell activation. A sCD30 concentration ! 40.3 U/ml on day 14 was able to discriminate between patients with or without biopsy-proven acute rejection (BPAR) with a sensitivity of 100% and a specificity of 76%. Six of seven patients (86%) with BPAR showed a sCD30 above this cut-off, whereas only 3/21 patients (14%) without BPAR had a sCD30 above this cut-off (P = 0.004). For pre-and post-transplant anti-HLA class II reactivities by enzyme-linked immunosorbent assay, a cut-off value of 140 optical density was able to discriminate rejecters from nonrejecters with a sensitivity of 86% or 71% and a specificity of 81% or 90%, respectively. Withdrawal of steroids was associated with a approximately twofold higher serum sCD30 compared to controls, but did not affect anti-HLA reactivities. An increased post-transplant sCD30 serum concentration and positive pre-and post-transplant anti-HLA class II reactivities are informative biomarkers for impending BPAR in pediatric renal transplant recipients. (TWIST,

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Section: Methodsmentioning

confidence: 99%

Soluble CD30 and ELISA-detected human leukocyte antigen antibodies for the prediction of acute rejection in pediatric renal transplant recipients

et al. 2012

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“…However, in all these studies, low numbers of patients with graft loss were investigated. We compared in sera of 51 patients with graft loss that were obtained prior to graft failure and in sera of matched controls with functioning grafts the incidence of de novo DSA and non-DSA [ 24 ]. Patients with graft loss showed a higher incidence of both DSA and non-DSA than patients without graft loss.…”

Section: Graft Survival After Development Of De Novo mentioning

confidence: 99%

Clinical Relevance of HLA Antibody Monitoring after Kidney Transplantation

Morath

Opelz

Zeier

et al. 2014

Journal of Immunology Research

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In kidney transplantation, antibody-mediated allograft injury caused by donor HLA-specific antibodies (DSA) has recently been identified as one of the major causes of late graft loss. This paper gives a brief overview on the impact of DSA development on graft outcome in organ transplantation with a focus on risk factors for de novo alloantibody induction and recently published guidelines for monitoring of DSA during the posttransplant phase.

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“…Based on findings from the CTS, we identified five different high‐risk groups: (i) patients with CDC‐PRA of 85% or more (either historical or current); (ii) patients with both HLA class I and class II antibody positivity in ELISA testing (first and retransplant recipients); (iii) retransplant recipients with HLA class I antibody positivity in ELISA; (iv) patients with a positive T‐cell crossmatch prior to antibody removal; or (v) retransplant recipients with a positive B‐cell crossmatch in the presence of HLA class II antibodies (5, 41–43). Categorization of patients at risk for early graft failure was not based on Luminex‐detected DSA as several reports by us and others now indicate that donor‐specific HLA antibodies detected exclusively by the highly sensitive solid‐phase Luminex technology are not associated with graft rejection (44–46). Furthermore, definition of unacceptable HLA antigens by Luminex technology may put the kidney transplant candidate in the case of deceased donor transplantation at a disadvantage due to prolonged waiting time.…”

Section: Special Programsmentioning

confidence: 99%

Current approaches to the management of highly sensitized kidney transplant patients

Süsal

Morath

2011

Tissue Antigens

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With the introduction of sensitive antibody detection techniques, effective antibody elimination devices, therapeutic agents, such as bortezomib and eculizumab, and new concepts, such as Heidelberg algorithm, kidney paired exchange, and acceptable mismatch programs, several effective options are now available for the management of highly sensitized kidney transplant patients. However, as the number of human leukocyte antigen-mismatched transplantations is increasing with each year and as long as the elimination or long-term control of donor-specific antibody-producing clones remains an unresolved issue, sensitization will continue to represent a major problem in kidney transplantation.

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Association of Kidney Graft Loss with Posttransplant Presence of Strong HLA Antibodies Detected by Luminex Single Antigen Testing

Cited by 4 publications

References 0 publications

Soluble CD30 and ELISA-detected human leukocyte antigen antibodies for the prediction of acute rejection in pediatric renal transplant recipients

Soluble CD30 and ELISA-detected human leukocyte antigen antibodies for the prediction of acute rejection in pediatric renal transplant recipients

Clinical Relevance of HLA Antibody Monitoring after Kidney Transplantation

Current approaches to the management of highly sensitized kidney transplant patients

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