Humoral Theory of Transplantation: Mechanism, Prevention, and Treatment

Cai, Junchao; Terasaki, Paul I.

doi:10.1016/j.humimm.2005.01.021

Cited by 101 publications

(58 citation statements)

References 85 publications

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“…The process speed of antibody-mediated rejection is associated with many factors, which include intensity of antibody, the capability of transplanted organ tissue repair, and the efficacy of immunosuppressive treatments. 10 A previous study demonstrated that de novo antibodies developed on average approximately 1 year after transplant, and led to an increase in serum creatinine > 2 mg/dL in an average of 29 months and graft failure in 44 months. 11 In some cases, it may take more than 10 years for an antibody to cause graft failure.…”

Section: Discussionmentioning

confidence: 99%

Detection of Antibodies Against Major Histocompatibility Complex Class I-Related Chain A in Long-term Renal Graft Recipients

Luo²,

Qiu³

et al. 2012

Exp Clin Transplant

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Objectives: To determine the prevalence, allele specificity, and intensity of anti-MICA antibodies in long-term renal graft recipients and to investigate their association with impaired renal function. Materials and Methods: Sixty-eight long-term (> 10 y) renal graft recipients were divided into 2 groups: (1) patients with impaired renal function (serum creatinine ≥ 2 mg/dL, n=6); (2) patients with normal renal function (serum creatinine < 176.8 µmol/L, n=62). Anti-MICA antibodies were tested using Luminex single antigen beads assays and the frequency, specificity, and intensity of these antibodies were compared between 2 patient groups. Results: MICA antibodies were detected in 33% of impaired renal function patients and 15% of normal renal function patients (P > .05). Anti-MICA*027 antibodies were found in 11.76% of patients, whereas antibody to MICA*012 was found in 2.94% of patients. Interestingly, among all antibody specificities, MICA*001,*004, *007, *009, *012, and *018 were found more frequently in impaired renal function patients than in normal renal function patients. The peak mean fluorescence intensity levels of MICA antibodies in impaired renal function patients were significantly higher than those in normal renal function patients (P < .05). Conclusions: Our data suggest that increased prevalence and intensity of anti-MICA antibodies are associated with impaired renal graft function in long-term renal graft recipients and some MICA antibodies might be more important than others in mediating graft rejection.

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Section: Discussionmentioning

confidence: 99%

Detection of Antibodies Against Major Histocompatibility Complex Class I-Related Chain A in Long-term Renal Graft Recipients

Luo²,

Qiu³

et al. 2012

Exp Clin Transplant

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“…The consequences of blood clot formation in the vasculature include ischemia and even infarction of graft tissues supplied by clotted vessels. The secondary tissue damage following primary endothelial injury will further deteriorate the allograft function, which finally results in graft failure [30]. In ABO-compatible intestinal transplantation (e.g.…”

Section: Discussionmentioning

confidence: 99%

Is ABO-Compatible but Non-Identical Intestinal Transplant Comparable to ABO-Identical Transplant? An Analysis of the UNOS Registry

Cai¹

2015

SOJI

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SOJ ImmunologyOpen Access Research Article survival in the heart [1,2], lung [3,4], and liver [5] transplants. However, careful investigation of these studies demonstrates that ABO-compatible transplants have lower graft survival than identical transplants in some of these studies, though the differences do not reach statistical significance. Koukoutisis [6] and Bjoro [7] reported that ABO-compatible liver transplant recipients actually have significantly lower graft and patient survival than ABO-identical transplant patients.Compared to other organ transplantation, intestinal transplantation remains the least frequently performed transplantation. There are more than 40 US centers performing intestinal transplants and case numbers in recent years were only around 100 per year in the US, with most centers performing fewer than 10 transplants per year [8]. With limited intestinal transplant cases, it is very difficult or it may take a long time for a single center to provide convincing evidence to show whether ABO-compatible and identical transplants have comparable graft outcome, especially long-term outcome. Our recent analysis demonstrated that during 1990-2013, 9.7% of US intestinal recipients received transplants from ABO-compatible donors. More importantly, we found there was a very significant increasing trend of ABO-compatible intestinal transplants in recent years (from 4% to 16%). These findings make it urgent to know whether it is safe to perform ABO-compatible intestinal transplantation and what we should do to minimize the potential risk if the ABO-compatible transplant is associated with graft failure. By analyzing US national registry data, we show the current status of ABO-compatible intestinal transplantation in the US and its detrimental effects on short-and long-term intestinal allograft outcomes. We also discuss the potential mechanisms of graft-versus-host reaction-induced graft injury and corresponding strategies. Materials and Methods Study populationBetween 1/1/1990 and 6/27/2013, a total of 2,287 US intestinal transplants were reported to the Organ Procurement Absract ABO-compatible intestinal transplants have been more frequently performed in the US in recent years (from 4% to 16%). However, they have not been clearly shown to have comparable short-and long-term graft outcome compared to ABO-identical transplants.The US national registry database was analyzed to show the current status of ABO-compatible intestinal transplantation and to determine its effect on acute rejection and long-term graft survival.Blood type A, B, and AB patients received 11%, 26%, and 62% of ABO-compatible intestinal transplants, respectively. ABO-compatible transplant recipients experienced a higher rate of acute rejection than ABO-identical patients (77% vs. 64%, p < 0.0001). In addition, they had a significantly lower 10-year graft survival rate than ABO-identical transplant recipients (27% vs. 35%, p = 0.020). Acute rejection was the cause of graft failure in 42% of ABO-compatible and 25% of ABOidentical pat...

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“…This disease is considered to be a major cause of long-term renal allograft dysfunction, and a variety of immune and non-immune processes can contribute to its development. [20][21][22] Chronic antibody-mediated humoral rejection has been shown to be a significant cause of longterm graft failure, especially in renal transplant recipients with DSA pre-transplant, adversely affecting the outcome of graft. In addition it has been reported that the level of pretransplant DSA was associated with the occurrence of AMR.…”

Section: Discussionmentioning

confidence: 99%

Pre-transplant low level HLA antibody shows a composite poor outcome in long-term outcome of renal transplant recipients

Tian

Alberghini

et al. 2015

Renal Failure

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To determine the significance of low-level DSA (donor specific antibody) in patients transplanted with negative cytotoxicity AHG (antihuman immunoglobulin) crossmatch, data from 279 patients who received a kidney transplant between July 1999 and March 2006 were collected. All kidney recipients received ABO-compatible donors. A poor outcome was defined as any one of the following: death, Cr42.0 mmol/L, occurrence of a rejection episode. Luminex Screening and Single Antigen assays from Tepnel Life Codes were used to detect human leukocyte antigen antibodies on pre-transplant sera retrospectively. Twenty-four out of 279 recipients demonstrated the presence of solid-phase DSA (MFI41000) present pre-transplant. In DSA+ group, the accumulated good versus poor outcome rate was 0.30 versus 0.70, respectively. These rates were 0.49 and 0.51, respectively, in the DSAÀ group. The difference in composite poor outcome between DSA+ versus DSAÀ group was significant (p ¼ 0.030). The DSAÀ group had no difference in patient survival as compared to the DSA+ group (p ¼ 0.061). There is no statistically significant difference for either mortality or outcome results between high MFI (42000) and low MFI ( 2000) groups. Our data suggest that solid-phase antibodies which are not strong enough to elicit a positive T-AHG crossmatch may influence long-term graft outcome.

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Humoral Theory of Transplantation: Mechanism, Prevention, and Treatment

Cited by 101 publications

References 85 publications

Detection of Antibodies Against Major Histocompatibility Complex Class I-Related Chain A in Long-term Renal Graft Recipients

Detection of Antibodies Against Major Histocompatibility Complex Class I-Related Chain A in Long-term Renal Graft Recipients

Is ABO-Compatible but Non-Identical Intestinal Transplant Comparable to ABO-Identical Transplant? An Analysis of the UNOS Registry

Pre-transplant low level HLA antibody shows a composite poor outcome in long-term outcome of renal transplant recipients

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