Journal ArticleDOI
All chronic rejection failures of kidney transplants were preceded by the development of HLA antibodies
Po-Chang Lee,Paul I. Terasaki,Steven K. Takemoto,Po-Huang Lee,Chung-Jye Hung,Yi Lin Chen,Alen Tsai,Huan Yao Lei +7 more
TLDR
It is concluded that HLA antibodies may be a prerequisite for chronic immunologic rejection, and 29 consecutive cases of chronic rejection failures as much as one year before the loss of grafts were found.Abstract:
Background. Recent studies show that almost all patients who have rejected a kidney transplant had human leukocyte antigen (HLA) antibodies. In this study, we sought to determine whether patients develop HLA antibodies before chronic rejection. Methods. For the past 8 years, 139 patients who had undergone kidney transplantation were systematically examined, using an enzyme-linked immunosorbent assay-based method, for the development of class-I and class-II HLA antibodies 3 months, 6 months, and yearly after transplantation. Chronic rejection was diagnosed by biopsy. Results. Among 29 patients with chronic rejection, 100% of the patients had HLA antibodies before rejection. Of these patients, 14 patients developed antibodies de novo. In contrast, among 110 patients with stable function, 27% of the patients developed HLA antibodies posttransplant (P<0.001). Conclusions. HLA antibodies were found in 29 consecutive cases of chronic rejection failures as much as one year before the loss of grafts. We conclude that HLA antibodies may be a prerequisite for chronic immunologic rejection.read more
Citations
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Journal ArticleDOI
Evolution and Clinical Pathologic Correlations of De Novo Donor‐Specific HLA Antibody Post Kidney Transplant
Chris Wiebe,Ian W. Gibson,Tom Blydt-Hansen,Martin Karpinski,Julie Ho,Leroy Storsley,Aviva Goldberg,Patricia E. Birk,David N. Rush,Peter Nickerson +9 more
TL;DR: Pathology consistent with antibody‐mediated injury can occur and progress in patients with dnDSA in the absence of graft dysfunction and furthermore, nonadherence and cellular rejection contribute to dNDSA development and progression to graft loss.
Journal ArticleDOI
Consensus guidelines on the testing and clinical management issues associated with HLA and non-HLA antibodies in transplantation.
Brian D. Tait,Caner Süsal,Howard M. Gebel,Peter Nickerson,Andrea A. Zachary,Frans H.J. Claas,Elaine F. Reed,Robert A. Bray,Patricia Campbell,Jeremy R. Chapman,P. Toby Coates,Robert B. Colvin,Emanuele Cozzi,Ilias I.N. Doxiadis,Susan V. Fuggle,John S. Gill,Denis Glotz,Nils Lachmann,Thalachallour Mohanakumar,Nicole Suciu-Foca,Suchitra Sumitran-Holgersson,Kazunari Tanabe,Craig J. Taylor,Dolly B. Tyan,Angela C Webster,Adriana Zeevi,Gerhard Opelz +26 more
TL;DR: A group of laboratory and clinical experts in the field of transplantation was convened to prepare a consensus report and make recommendations on the use of this new technology based on both published evidence and expert opinion.
Journal ArticleDOI
Desensitization in HLA-incompatible kidney recipients and survival.
Robert A. Montgomery,Bonnie E. Lonze,Karen E. King,Edward S. Kraus,Lauren M. Kucirka,Jayme E. Locke,Daniel S. Warren,Christopher E. Simpkins,Nabil N. Dagher,Andrew L. Singer,Andrea A. Zachary,Dorry L. Segev +11 more
TL;DR: Live-donor transplantation after desensitization provided a significant survival benefit for patients with HLA sensitization, as compared with waiting for a compatible organ.
Journal ArticleDOI
Humoral Theory of Transplantation
TL;DR: 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).
Journal ArticleDOI
Antibody-mediated organ-allograft rejection
Robert B. Colvin,R. Neal Smith +1 more
TL;DR: Antibody induces rejection acutely through the fixation of complement, resulting in tissue injury and coagulation, and complement activation recruits macrophages and neutrophils, causing additional endothelial injury.
References
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Journal ArticleDOI
Anti-HLA antibodies after solid organ transplantation.
TL;DR: It is predicted that recently developed ELISA and flow cytometry techniques using purified HLA antigen will increase the clinical relevance of posttransplantation HLA antibody monitoring by allowing the detection of low levels of donor antibody and easily distinguishing the isotype and target (HLA class I or class II) of the antibodies.
Journal ArticleDOI
Development of ELISA-detected anti-HLA antibodies precedes the development of bronchiolitis obliterans syndrome and correlates with progressive decline in pulmonary function after lung transplantation.
Andrés Jaramillo,Michael D. Smith,Donna Phelan,Sudhir Sundaresan,Elbert P. Trulock,John Lynch,Joel D. Cooper,G.A. Patterson,T. Mohanakumar +8 more
TL;DR: Monitoring of anti-HLA class I antibody development by a highly sensitive assay such as the PRA-STAT ELISA after LT can provide an early identification of an important subset of LT patients with an increased risk of developing BOS.
Journal ArticleDOI
Control of antidonor antibody production with tacrolimus and mycophenolate mofetil in renal allograft recipients with chronic rejection.
Tom P. Theruvath,Susan L. Saidman,Shamila Mauiyyedi,Francis L. Delmonico,Winfred W. Williams,Nina Tolkoff-Rubin,A. Bernard Collins,Robert B. Colvin,A. Benedict Cosimi,Manuel Pascual +9 more
TL;DR: It is suggested that a decrease in DSA production can be induced in renal allograft recipients with 'chronic humoral rejection' by using an immunosuppressive regimen that combines tacrolimus and mycophenolate mofetil.
Journal ArticleDOI
Flow cytometric detection of HLA-specific antibodies as a predictor of heart allograft rejection.
Anat R. Tambur,Robert A. Bray,Takemoto S,M Mancini,Maria Rosa Costanzo,Jon A. Kobashigawa,C. D’Amico,Kirk R. Kanter,Alexandria M. Berg,J.D. Vega,A. L. Smith,A L Roggero,John W. Ortegel,Lisa Wilmoth-Hosey,J M Cecka,H M Gebel,H M Gebel +16 more
TL;DR: It is suggested that pre- and posttransplant HLA antibodies detectable by FlowPRA and not AHG-CDC identify cardiac allograft recipients at risk for rejection and a positive donor reactive flow cytometric cross-match is significantly associated with graft loss.
Journal ArticleDOI
Almost all patients who are waiting for a regraft of a kidney transplant have anti-HLA antibodies.
TL;DR: A larger series of patients who rejected a kidney in five different transplant centers is examined to determine whether essentially all patients who reject a graft have HLA antibodies.
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