Posttransplant immune monitoring of anti-HLA antibody

Kerman, Ronald H.; Katz, Stephen M.; Buren, Charles T. Van; Ruth, J.; McKissick, Eva; Rasmussen, Shelley L.; Kahan, B.D.

doi:10.1016/s0041-1345(00)02066-2

Cited by 3 publications

(6 citation statements)

References 2 publications

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“…Since publication of this review, 10 further papers have been published that show the same type of association for kidneys (17,79–83), kidney‐pancreas (84), heart (30), and lungs (85,86) .…”

Section: Hla Antibodies Are Associated With Chronic Rejectionmentioning

confidence: 88%

Humoral Theory of Transplantation

Terasaki

2003

American Journal of Transplantation

546

385

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According to the humoral theory of transplantation, antibodies cause allograft rejection. Publications are cited showing that antibodies: (1) cause hyperacute kidney rejection, (2) lead to C4d deposits associated with early kidney graft failures, (3) are a good indicator of presensitization leading to early acute rejections, (4) were present in 96% of 826 patients who rejected a kidney graft, (5) are associated with chronic rejection in 33 studies of kidney, heart, lung and liver grafts, and (6) in three studies, appeared in the circulation BEFORE evidence of bronchiolitis obliterans in lung transplants, and BEFORE kidney rejection. In addition, a prospective cooperative study of 1629 patients in 24 centers demonstrated that antibodies foretold subsequent failures after a follow‐up period of 6 months (p = 0.05). The specificity of antibodies detected in the serum of rejecting patients were often not donor specific, presumably because they were absorbed by the rejecting organ. If the humoral theory is accepted, even provisionally, transplanted patients who have antibodies could be treated with immunosuppression until the antibodies disappear to determine whether chronic rejection can be blocked. If successful, in patients who do not have antibodies, immunosuppression could be reduced until antibodies appear.

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Section: Hla Antibodies Are Associated With Chronic Rejectionmentioning

confidence: 88%

Humoral Theory of Transplantation

Terasaki

2003

American Journal of Transplantation

546

385

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“…All renal transplants were performed following a negative cross‐match by complement dependent cytotoxicity (CDC) enhanced with antihuman globulin (CDC‐AHG) and flow cytometry using a fluorescein conjugated anti‐human immunoglobulin reagent (One Lambda Inc., Canoga Park, CA, USA). Anti‐Class I and Class II HLA PRA determinations were performed before transplantation on all patients using CDC‐AHG and flow cytometry techniques [One Lambda Inc.; FLOWPRA Screening Test; (23, 24)]. DSA was also evaluated by microbead technology in flow cytometry with goat anti‐human IgG‐phycoerythrin (One Lambda Inc.; FLOWPRA Specific Antibody Detection Test; combined single antigen kits (LS1AO1AO2) (23, 24).…”

Section: Methodsmentioning

confidence: 99%

“…Anti‐Class I and Class II HLA PRA determinations were performed before transplantation on all patients using CDC‐AHG and flow cytometry techniques [One Lambda Inc.; FLOWPRA Screening Test; (23, 24)]. DSA was also evaluated by microbead technology in flow cytometry with goat anti‐human IgG‐phycoerythrin (One Lambda Inc.; FLOWPRA Specific Antibody Detection Test; combined single antigen kits (LS1AO1AO2) (23, 24).…”

Section: Methodsmentioning

confidence: 99%

Impact of rituximab therapy for treatment of acute humoral rejection

Kaposztas

Podder²,

Mauiyyedi³

et al. 2009

Clinical Transplantation

Self Cite

117

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“…Pre-transplant PRAs and donor-specific anti-HLA antibodies are both associated with impaired outcomes (69). Transplant recipients who develop anti-HLA antibodies post-transplant experience more rejection episodes (19,64,68,(70)(71)(72)(73)(74)(75). In some studies, the magnitude of the rise in antibody levels was related to the severity of graft rejection (19,71).…”

Section: Anti-hla Antibodies Associated With Late Graft Deteriorationmentioning

confidence: 99%

“…Four studies demonstrate correlation between late graft deterioration and anti-HLA antibodies. Patients who produce anti-HLA antibodies post kidney transplantation manifest more late graft dysfunction and graft loss (65,68,76,77). Graft survival in patients with anti-HLA antibodies detected by complement-dependent cytotoxicity, ELISA assay, and flow cytometry is reduced (65,68,70,72,74,75,(77)(78)(79)(80)(81).…”

Section: Anti-hla Antibodies Associated With Late Graft Deteriorationmentioning

confidence: 99%

The role of B cells and alloantibody in the host response to human organ allografts

Vongwiwatana

Tasanarong

Hidalgo

et al. 2003

Immunological Reviews

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Some human organ transplants deteriorate slowly over a period of years, often developing characteristic syndromes: transplant glomerulopathy (TG) in kidneys, bronchiolitis obliterans in lungs, and coronary artery disease in hearts. In the past, we attributed late graft deterioration to "chronic rejection", a distinct but mysterious immunologic process different from conventional rejection. However, it is likely that much of chronic rejection is explained by conventional T-cell-mediated rejection (TMR), antibody-mediated rejection (AMR), and other insults. Recently, criteria have emerged to now permit us to diagnose AMR in kidney transplants, particularly C4d deposition in peritubular capillaries and circulating antibody against donor human leukocyte antigens (HLA). Some cases with AMR develop TG, although the relationship of TG to AMR is complex. Thus, a specific diagnosis of AMR in kidney can now be made, based on graft damage, C4d deposition, and donor-specific alloantibodies. Criteria for AMR in other organs must be defined. Not all late rejections are AMR; some deteriorating organs probably have smoldering TMR. The diagnosis of late ongoing AMR raises the possibility of treatment to suppress the alloantibody, but efficacy of the available treatments requires further study.

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Posttransplant immune monitoring of anti-HLA antibody

Cited by 3 publications

References 2 publications

Humoral Theory of Transplantation

Humoral Theory of Transplantation

Impact of rituximab therapy for treatment of acute humoral rejection

The role of B cells and alloantibody in the host response to human organ allografts

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