Posttransplant Antidonor Antibodies and Graft Rejection

Scornik, Juan C.; Salomon, Daniel R.; Lim, Paul B.; Howard, Richard J.; Pfaff, William

doi:10.1097/00007890-198902000-00018

Cited by 77 publications

(39 citation statements)

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“…Whereas earlier studies using CDC methods and FC suggested that IgM antibodies are not detrimental to the graft (28), a recent study found that a positive T cell IgM FC cross-match at the time of transplantation could be a risk factor for allograft rejection (29). A prospective study of cadaveric kidney transplant recipients by FC demonstrated that 40% of the patients with acute rejection had IgG type antibodies, whereas only 9% of the nonrejecting patients developed alloantibodies that were exclusively IgM type (6). Despite lack of definitive studies, most centers find that pretransplantation DS IgM type anti-HLA antibodies are not relevant as risk factors for acute rejection, and the same might be true after transplantation.…”

Section: Type Of Antibody and Its Effect On Allograft Outcomementioning

confidence: 99%

Sensitization after Kidney Transplantation

Akalin¹,

Pascual²

2006

Clinical Journal of the American Society of Nephrology

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Kidney transplant recipients may develop de novo anti-HLA and non-HLA antibodies after transplantation. Although these antibodies may be donor-specific or non-donor-specific, their presence may increase the risk for acute and chronic rejection, thereby decreasing allograft survival. The introduction of more sensitive and specific methods to detect anti-HLA antibodies, such as Flow Specific Beads and FlowPRA, both before and after transplantation, will help to define immunologically high-risk kidney transplant recipients. Thus, posttransplantation monitoring of anti-HLA antibody production will allow the identification of kidney transplant recipients who might be at increased risk for late allograft failure. Moreover, knowledge of alloantibody status after transplantation may help to guide the appropriate use of immunomodulatory agents to downregulate anti-HLA antibody production.

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Section: Type Of Antibody and Its Effect On Allograft Outcomementioning

confidence: 99%

Sensitization after Kidney Transplantation

Akalin¹,

Pascual²

2006

Clinical Journal of the American Society of Nephrology

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“…Up to now, the techniques described to perform the CM test by means of FC [9,10,14] have been based on an indirect immunofluorescence assay allowing detection of serum antibodies able to fix themselves on the surface of donor lymphocytes. However, despite an undeniable in crease in sensitivity compared to standard light micros copy [15], it has become clear that the antibodies detected by such assays did not have the same cytotoxic activity as those revealed by the standard technique.…”

Section: Discussionmentioning

confidence: 99%

Validity of Flow Cytometry for Cross-Match Evaluation in Clinical Renal Transplantation

Stefoni

Nanni-Costa²,

Buscaroli³

et al. 1991

Nephron

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This paper reports a 2-year experience of more than 5,000 cross-match tests for renal transplantation. Tests were performed by means of both standard light microscopy and an innovatory method based on now cytometry, an up-to-date investigative technique for computerized analysis of individual cell characteristics. Flow cytometry allowed a better detection of weak positive reactions (false-negative cross-matches) than light microscopy, thus reducing the risk of selecting candidates with donor presensitization. Transplant clinical outcome supported the value of this original and advanced technological method.

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“…Numerous studies have indicated a 2-to 10-fold higher incidence of acute rejection in the presence of HLA antibodies [16,[17][18][19][20][21][22]. The CDC method is a functional test because it detects complement-fixing antibodies (immunoglobulin (Ig)-M, IgG1, and IgG3) and these antibodies have been regarded as detrimental to the graft [3].…”

Section: Role Of Hla Antibodies In Renal Allograft Rejectionmentioning

confidence: 99%

“…Studies of renal recipients using flow cytometry have indicated that only IgG and not IgM HLA antibody are associated with acute and chronic rejection [16,22]. Other studies have demonstrated that IgG is associated with more severe rejection than IgM antibody [32], whereas anti-HLA class II responses have been strongly associated with chronic rejection in recipients of living-donor kidneys [24].…”

Section: Role Of Hla Antibodies In Renal Allograft Rejectionmentioning

confidence: 99%