Donor-Directed HLA Antibodies Before and After Transplantectomy Detected by the Luminex Single Antigen Assay

Billen, Evy V.A.; Christiaans, Maarten H. L.; Lee, JarHow; Berg‐Loonen, Ella M. van den

doi:10.1097/tp.0b013e3181949e37

Cited by 52 publications

(40 citation statements)

References 32 publications

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…Allograft nephrectomy and the number of anti-HLA class I mismatches were the only two independent predictive factors for de novo DSAs after graft loss and cessation of immunosuppressive therapy. In patients who had an allograft nephrectomy, the work by Billen et al (7) found that donor age was a predictive factor for de novo DSAs, whereas the work by Knight et al (17) found that both the number of rejection episodes and having a ,10-month interval between graft failure and allograft nephrectomy were both significantly associated with greater percentages of panel-reactive antibodies and mean DSA levels.…”

Section: Discussionmentioning

confidence: 80%

Donor-Specific Antibodies after Ceasing Immunosuppressive Therapy, with or without an Allograft Nephrectomy

Bello

Congy‐Jolivet

Sallusto

et al. 2012

Clinical Journal of the American Society of Nephrology

View full text Add to dashboard Cite

SummaryBackground and objectives Within the last few years, anti-human leukocyte antigen detection assays have significantly improved. This study asked, using the Luminex single-antigen assay, whether an allograft nephrectomy allowed donor-specific alloantibodies to appear that were not previously detected in the serum when the failed kidney was still in place.Design, setting, participants, & measurements After losing the kidney allograft and stopping immunosuppressive therapy, the proportions of donor-specific alloantibodies and nondonor-specific alloantibodies were compared in patients who had (n=48; group I) and had not (n=21; group II) undergone an allograft nephrectomy. Allograft nephrectomies were performed at 150 days after kidney allograft loss, and the time between allograft nephrectomy and last follow-up was 5386347 days.Results At kidney allograft loss, donor-specific alloantibodies were detected in three group II patients (14.2%) and six group I patients (12.5%). At last follow-up, donor-specific alloantibodies were detected in 11 patients (52.4%) without and 39 patients (81%) with an allograft nephrectomy (P=0.02). Anti-human leukocyte antigen class I donor-specific alloantibodies were positive in 23.8% of group II and 77% of group I patients (P,0.001); antihuman leukocyte antigen class II donor-specific alloantibodies were positive in 42.8% of group II and 62.5% of group I patients. Independent predictive factors for developing donor-specific alloantibodies after losing kidney allograft and stopping immunosuppressants were number of anti-human leukocyte antigen A/B mismatches at transplantation (zero versus one or more) and allograft nephrectomy.Conclusions The development of donor-specific alloantibodies was significantly greater in patients with a failed kidney who had undergone an allograft nephrectomy compared with those patients who had not undergone allograft nephrectomy.

show abstract

Section: Discussionmentioning

confidence: 80%

Donor-Specific Antibodies after Ceasing Immunosuppressive Therapy, with or without an Allograft Nephrectomy

Bello

Congy‐Jolivet

Sallusto

et al. 2012

Clinical Journal of the American Society of Nephrology

View full text Add to dashboard Cite

show abstract

“…Nevertheless, we think that renovascular resistance can be a valuable parameter next to other factors to decide whether to transplant a kidney or not. Moreover, in our series, 6 out of 7 kidneys with a renovascular resistance at T 0 of >3.0 mmHg/mL/min/100 g resulted in PNF, which is unacceptably high because transplantation of nonviable kidneys results in unnecessary risk of surgery and immunosuppression, and sensitizes the recipient for future transplants (30). Kidneys with DGF had a higher renovascular resistance than immediately functioning kidneys; this finding, however, should not have clinical implications, as long-term survival rates of DCD kidneys with DGF do not significantly differ from DCD kidneys with IF (4,5,13,19,20,31).…”

Section: Discussionmentioning

confidence: 99%

Renovascular Resistance of Machine-Perfused DCD Kidneys Is Associated with Primary Nonfunction

Vries

Hoogland

Winkens

et al. 2011

American Journal of Transplantation

View full text Add to dashboard Cite

Donation after cardiac death (DCD) has shown to be a valuable extension of the donor pool despite a higher percentage of primary nonfunction (PNF). Limiting the incidence of PNF is of vital importance. Renovascular resistance is believed to predict graft outcome; however the literature is inconsistent. Therefore, we studied whether renovascular resistance is associated with PNF and whether this parameter should be used to discard donor kidneys. All transplanted DCD kidneys preserved by machine perfusion at our center between 1993 and 2007 were analyzed (n = 440). The effects of renovascular resistance on PNF, delayed graft function (DGF), and graft and patient survival were examined using multivariable analyses; predictive quality by calculating the area under the curve (AUC). We showed that renovascular resistance at the start of machine perfusion was significantly and independently associated with PNF (OR 2.040, 95% CI 1.362-3.056; p = 0.001), and DGF (OR 2.345, 95% CI 1.110-4.955; p = 0.025). Predictive quality was moderate (0.609, 95% CI 0.538-0.681). Graft and patient survival were not associated with renovascular resistance. We conclude that renovascular resistance in DCD kidneys is an independent risk factor for PNF; however, the predictive value is relatively low.

show abstract

“…FC CM is the most sensitive immunological method and it allows for the detection of DSA in TC serum. Positive FC CM is associated with an elevated risk of AMR [12,16,17,21,32,[104][105][106][107] . The accurate detection of the spectrum of anti-HLA antibodies is critical for organ allocation and the prediction of FC CM results.…”

Section: Luminex Sa Sp Assay: Technical Challenges Correlation Of Dsamentioning

confidence: 99%

“…One of the limitations of SA SP Luminex technology detailed in the literature is non-specific reactivity [90,106] . The main reasons for high background levels may be related to antibodies reacting to latex, autoimmune disease(s), and some medications (IVIG) [75,[115][116][117] .…”

Section: Non-specific Antibody Reactivitymentioning

confidence: 99%

Methodological aspects of anti-human leukocyte antigen antibody analysis in solid organ transplantation

Lobashevsky¹

2014

WJT

View full text Add to dashboard Cite

Donor human leukocyte antigen (HLA)-specific antibodies (DSA) play an important role in solid organ transplantation. Preexisting IgG isotype DSA are considered a risk factor for antibody mediated rejection, graft failure or graft loss. The post-transplant development of DSA depends on multiple factors including immunogenicity of mismatched antigens, HLA class Ⅱ typing of the recipient, cytokine gene polymorphisms, and cellular immunoregulatory mechanisms. De novo developed antibodies require special attention because not all DSA have equal clinical significance. Therefore, it is important for transplant clinicians and transplant immunologists to accurately characterize DSA. In this review, the contemporary immunological techniques for detection and characterization of anti-HLA antibodies and their pitfalls are described.

show abstract

Donor-Directed HLA Antibodies Before and After Transplantectomy Detected by the Luminex Single Antigen Assay

Cited by 52 publications

References 32 publications

Donor-Specific Antibodies after Ceasing Immunosuppressive Therapy, with or without an Allograft Nephrectomy

Donor-Specific Antibodies after Ceasing Immunosuppressive Therapy, with or without an Allograft Nephrectomy

Renovascular Resistance of Machine-Perfused DCD Kidneys Is Associated with Primary Nonfunction

Methodological aspects of anti-human leukocyte antigen antibody analysis in solid organ transplantation

Contact Info

Product

Resources

About