Effect of panel-reactive antibody positivity on graft rejection before or after kidney transplantation

Lee, Kwang‐Woong; Kim, S. J.; Lee, D. S.; Lee, H. H.; Joh, Jae‐Won; Lee, S. K.; Oh, Ha Young; Kim, D. J.; Kim, Y. G.; Huh, Wooseong; Oh, Wonwoo; Lee, B. B.

doi:10.1016/j.transproceed.2004.08.137

Cited by 25 publications

(15 citation statements)

References 4 publications

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“…Sensitization has a significant impact on both access and outcome in transplantation, as it has been well documented that these patients wait longer to receive a transplant (1) and are more likely to experience an acute rejection episode in the post-transplant period (4,5). The presence of HSA prior to transplantation is correlated with higher rates of AMR and graft loss after transplantation (7)(8)(9)(10) (15)(16)(17).…”

Section: Discussionmentioning

confidence: 99%

“…Importantly, without frequent monitoring, such an increase in HSA may go undetected and result in an unexpected positive crossmatch (+XM). Sensitized patients are known to have poorer outcomes after transplantation (2)(3)(4)(5)(6)(7)(8)(9)(10). The increased incidence of acute rejection and graft loss is often antibody mediated and is related to the patient's prior sensitization (11).…”

Section: Introductionmentioning

confidence: 99%

See 1 more Smart Citation

Proinflammatory Events Are Associated with Significant Increases in Breadth and Strength of HLA-Specific Antibody

Locke¹,

Zachary

Warren³

et al. 2009

American Journal of Transplantation

117

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Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Proinflammatory Events Are Associated with Significant Increases in Breadth and Strength of HLA-Specific Antibody

Locke¹,

Zachary

Warren³

et al. 2009

American Journal of Transplantation

117

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“…The presence of PRA >0% has been a widely accepted marker for acute rejection risk after kidney transplantation based on retrospective and prospective data, and PRA level is uniformly included as a criteria for ‘high‐risk’ patients in clinical trials . Unexpectedly, Cole et al .…”

Section: Recipient Immunological Characteristicsmentioning

confidence: 99%

Pretransplant identification of acute rejection risk following kidney transplantation

et al. 2013

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SummaryLack of an accepted definition for 'high immunological risk' hampers individualization of immunosuppressive therapy after kidney transplantation. For recipientrelated risk factors for acute rejection, the most compelling evidence points to younger age and African American ethnicity. Recipient gender, body mass, previous transplantation, and concomitant infection or disease do not appear to be influential. Deceased donation now has only a minor effect on rejection risk, but older donor age remains a significant predictor. Conventional immunological markers (human leukocyte antigen [HLA] mismatching, pretransplant anti-HLA alloantibodies, and panel reactive antibodies) are being reassessed in light of growing understanding about the role of donor-specific antibodies (DSA). At the time of transplant, delayed graft function is one of the most clear-cut risk factors for acute rejection. Extended cold ischemia time (≥24 h) may also play a contributory role. While it is not yet possible to establish conclusively the relative contribution of different risk factors for acute rejection after kidney transplantation, the available data point to variables that should be taken into account at the time of transplant. Together, these offer a realistic basis for planning an appropriate immunosuppression regimen in individual patients.

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“…Lee et al [2] reported the graft rejection rate among renal allograft recipients. The graft rejection rate was 8.6% in recipients whose PRA score was zero.…”

Section: Discussionmentioning

confidence: 99%

A Successful Bilateral Lung Transplantation in a Patient with High Panel Reactive Antibody and Positive Cross Matching

Bok

Jun

Lee

et al. 2014

Korean J Thorac Cardiovasc Surg

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A 44-year-old pregnant female patient gave stillbirth while being treated for pneumonia. She developed acute respiratory failure, which resulted in mechanical ventilator support. Diagnostic lung biopsy revealed a cryptogenic organizing pneumonia. The patient’s condition deteriorated and a venous-venous extracorporeal membrane oxygenation was placed. She was listed for lung transplantation. Because of her worsening condition lung transplantation was performed despite positive cross matching result. She was treated with rituximab, intravenous immunoglobulin, and plasmapheresis and recovered without event. There is no sign of rejection at the time of last follow-up.

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Effect of panel-reactive antibody positivity on graft rejection before or after kidney transplantation

Cited by 25 publications

References 4 publications

Proinflammatory Events Are Associated with Significant Increases in Breadth and Strength of HLA-Specific Antibody

Proinflammatory Events Are Associated with Significant Increases in Breadth and Strength of HLA-Specific Antibody

Pretransplant identification of acute rejection risk following kidney transplantation

A Successful Bilateral Lung Transplantation in a Patient with High Panel Reactive Antibody and Positive Cross Matching

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