The Role of HLA in Renal Transplantation

Cecka, J. Michael

doi:10.1016/s0198-8859(97)00187-0

Cited by 21 publications

(14 citation statements)

References 60 publications

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“…HLA mismatching has been identified as a risk factor for BKVN in both retrospective and prospective studies among adult renal transplant patients (7,19). The increased rejection risk with HLA mismatching (21,22) through its treatment with escalation of immunosuppression and/or via direct rejectionrelated inflammatory responses has been proposed as a potential mechanism for this association. Other studies have not identified HLA mismatching as a risk factor (4,16,23).…”

Section: Discussionmentioning

confidence: 99%

BK Virus Nephropathy in Pediatric Renal Transplant Recipients

Smith

Dharnidharka

Talley³

et al. 2007

Clinical Journal of the American Society of Nephrology

119

104

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Section: Discussionmentioning

confidence: 99%

BK Virus Nephropathy in Pediatric Renal Transplant Recipients

Smith

Dharnidharka

Talley³

et al. 2007

Clinical Journal of the American Society of Nephrology

119

104

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“…Increasing numbers of mismatches resulted in progressively lower survival rates [75][76][77][78]. Although HLA antigens were initially determined by serologic typing methods using alloantibody, several laboratories now use more precise DNAbased typing technologies.…”

Section: What Is Meant By Hla Match?mentioning

confidence: 99%

HLA matching for kidney transplantation

et al. 2004

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“…Several lines of evidence implicate immunological factors in the pathogenesis of CAN. First, the t 1/2 of allografts are inversely related to the number of HLA mismatches, whether they be from live or cadaveric donors (1). Second, several studies have shown a strong association between the development of acute rejection and the subsequent development of CAN, suggesting that the two processes may be related (2,3).…”

Section: Hronic Allograft Nephropathy (Can)mentioning

confidence: 99%

Loss of Direct and Maintenance of Indirect Alloresponses in Renal Allograft Recipients: Implications for the Pathogenesis of Chronic Allograft Nephropathy

Baker¹,

Hernandez-Fuentes²,

Brookes³

et al. 2001

The Journal of Immunology

192

152

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Chronic allograft nephropathy (CAN) is the principal cause of late renal allograft failure. This complex process is multifactorial in origin, and there is good evidence for immune-mediated effects. The immune contribution to this process is directed by CD4+ T cells, which can be activated by either direct or indirect pathways of allorecognition. For the first time, these pathways have been simultaneously compared in a cohort of 22 longstanding renal allograft recipients (13 with good function and nine with CAN). CD4+ T cells from all patients reveal donor-specific hyporesponsiveness by the direct pathway according to proliferation or the secretion of the cytokines IL-2, IL-5, and IFN-γ. Donor-specific cytotoxic T cell responses were also attenuated. In contrast, the frequencies of indirectly alloreactive cells were maintained, patients with CAN having significantly higher frequencies of CD4+ T cells indirectly activated by allogeneic peptides when compared with controls with good allograft function. An extensive search for alloantibodies has revealed significant titers in only a minority of patients, both with and without CAN. In summary, this study demonstrates widespread donor-specific hyporesponsiveness in directly activated CD4+ T cells derived from longstanding recipients of renal allografts, whether they have CAN or not. However, patients with CAN have significantly higher frequencies of CD4+ T cells activated by donor Ags in an indirect manner, a phenomenon resembling split tolerance. These findings provide an insight into the pathogenesis of CAN and also have implications for the development of a clinical tolerance assay.

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The Role of HLA in Renal Transplantation

Cited by 21 publications

References 60 publications

BK Virus Nephropathy in Pediatric Renal Transplant Recipients

BK Virus Nephropathy in Pediatric Renal Transplant Recipients

HLA matching for kidney transplantation

Loss of Direct and Maintenance of Indirect Alloresponses in Renal Allograft Recipients: Implications for the Pathogenesis of Chronic Allograft Nephropathy

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