Presensitization

Jordan, Stanley C.; Pescovitz, Mark D.

doi:10.2215/cjn.01651105

Cited by 110 publications

(82 citation statements)

References 63 publications

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“…Candidate recipients with pre-existing antibodies to potential donor grafts have a higher risk of rejection and eventually graft loss (1)(2)(3)(4)(5)(6). It is commonly accepted that these antibodies are either naturally pre-formed or had developed after exposure to allogeneic antigens occurring during pregnancy, blood transfusion or previous allografts.…”

Section: Introductionmentioning

confidence: 99%

Pre-Transplant IgG Reactivity to Apoptotic Cells Correlates With Late Kidney Allograft Loss.

Gao¹,

Moore²,

Porcheray³

et al. 2014

Transplantation

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Pre-existing serum antibodies have long been associated with graft loss in transplant candidates. While most studies have focused on HLA-specific antibodies, the contribution of non-HLAreactive antibodies has been largely overlooked. We have recently characterized monoclonal antibodies secreted by B cell clones derived from kidney allograft recipients with rejection that selectively bind to apoptotic cells. Here, we assessed the presence of such antibodies in pretransplant serum from 300 kidney transplant recipients and examined their contribution to the graft outcomes. Kaplan-Meier survival analysis revealed that patients with high pre-transplant IgG reactivity to apoptotic cells had a significantly increased rate of late graft loss. The effect was only apparent after approximately 1 year post-transplant. Moreover, the association between pretransplant IgG reactivity to apoptotic cells and graft loss was still significant after excluding patients with high reactivity to HLA. This reactivity was almost exclusively mediated by IgG1 and IgG3 with complement fixing and activating properties. Overall, our findings support the view that IgG reactivity to apoptotic cells contribute to pre-sensitization. Taking these antibodies into

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Section: Introductionmentioning

confidence: 99%

Pre-Transplant IgG Reactivity to Apoptotic Cells Correlates With Late Kidney Allograft Loss.

Gao¹,

Moore²,

Porcheray³

et al. 2014

Transplantation

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“…IVIg are also useful for pretransplantation desensitization of patients who have high levels of preformed anti-HLA antibodies and are awaiting renal transplantation (3) and, in combination with plasmapheresis, for the treatment of acute humoral rejection (4,5). Recently, our group also reported that the use of IVIg as a prophylactic therapy in patients at high immunologic risk was associated with good 1-yr outcome and a profound decrease in level of panel reactive antibodies (6).…”

mentioning

confidence: 99%

High-Dosage Intravenous Immunoglobulin–Associated Macrovacuoles Are Associated with Chronic Tubulointerstitial Lesion Worsening in Renal Transplant Recipients

Bollée¹,

Anglicheau²,

Loupy³

et al. 2008

Clinical Journal of the American Society of Nephrology

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Design, setting, participants, & measurements: Twenty-seven kidney transplant recipients who had high immunologic risk and were treated with four courses of IVIg after transplantation were studied retrospectively at a transplant center, and findings were compared with those of 27 control subjects. Protocol kidney biopsies were performed at time of transplantation and at 3 mo and 1 yr after transplantation.Results: No episode of IVIg-related acute renal failure occurred. Nevertheless, screening biopsies revealed the presence of "microvacuoles" and "macrovacuoles." Widespread microvacuolizations were often detected (70%) on preimplantation biopsy and not associated with IVIg. Macrovacuoles, which were absent on preimplantation biopsies, were observed exclusively in IVIg-treated patients. Macrovacuoles among IVIg-treated patients were seen in kidneys from older donors and were associated with chronic tubulointerstitial changes at 3 mo, with similar trends at 1 yr. Macrovacuoles were associated with lower creatinine clearance at last follow-up in IVIg-treated patients.Conclusions: IVIg frequently induce tubular macrovacuoles in kidney transplant recipients. These are more frequently observed in grafts from older donors, suggesting a higher vulnerability to IVIg. These data suggest a deleterious impact of IVIg-induced macrovacuoles on chronic tubulointerstitial changes and long-term renal function.

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“…Campath is a humanized mAb against CD52, a small glycosylphosphatidylinositol-anchored glycoprotein determinant that is highly expressed on both T and B cells. However, despite its reactivity against B cells, it has been unable to prevent and in fact may result in increased rates of C4d-positive acute humoral rejections (20). Our patient, in November 2003, 4 months after his renal transplant, had normal or slightly increased number of circulating B cells (34%, with an absolute count 126/lL) despite lymphopenia (total lymphocytes 7%, with a normal range of 15-50%).…”

Section: Remuzzi Used Rituximab Infusions (375 Mg/mmentioning

confidence: 63%

Anti-CD20 Monoclonal Antibody (Rituximab) for the Treatment of Recurrent Idiopathic Membranous Nephropathy in a Renal Transplant Patient

Gallon

Chhabra

2006

American Journal of Transplantation

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Presensitization

Cited by 110 publications

References 63 publications

Pre-Transplant IgG Reactivity to Apoptotic Cells Correlates With Late Kidney Allograft Loss.

Pre-Transplant IgG Reactivity to Apoptotic Cells Correlates With Late Kidney Allograft Loss.

High-Dosage Intravenous Immunoglobulin–Associated Macrovacuoles Are Associated with Chronic Tubulointerstitial Lesion Worsening in Renal Transplant Recipients

Anti-CD20 Monoclonal Antibody (Rituximab) for the Treatment of Recurrent Idiopathic Membranous Nephropathy in a Renal Transplant Patient

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