PMID- 17175290
OWN - NLM
STAT- MEDLINE
DCOM- 20070430
LR  - 20061218
IS  - 0041-1345 (Print)
IS  - 0041-1345 (Linking)
VI  - 38
IP  - 10
DP  - 2006 Dec
TI  - Desensitized renal transplant recipients show reduced cellular responses to in 
      vitro challenge.
PG  - 3416-7
AB  - Intravenous immunoglobulin (IVIG) desensitization protocols permit 
      transplantation of sensitized renal recipients against alloantibody 
      incompatibility barriers. It appears that IVIG induces a sustained 
      down-regulation of alloantibody that facilitates crossmatch compatibility. 
      However, the consequence of desensitization upon cellular immunity has not been 
      addressed. We compared in vitro proliferative responses and cytokine expression 
      between desensitized transplant recipients (IVIG) and non-IVIG-treated patients 
      (controls). Eleven patients who were crossmatch-incompatible with living donors 
      underwent treatment with IVIG and plasmapheresis. Nine patients converted to 
      negative crossmatches and were transplanted. With a mean follow-up time of 17.6 
      +/- 6.7 months, graft survival is 100%. Peripheral mononuclear cells were 
      collected 12.5 +/- 9 months after transplantation and tested for proliferative 
      response and cytokine elaboration following challenge with staphylococcal 
      enterotoxin b (SEB) and donor-specific mixed lymphocyte reaction (dMLR). 
      Proliferative reactions were 90% lower (P < .05) among IVIG versus controls in 
      response to SEB and dMLR challenge. Cytokine response to SEB challenge was 
      equivalent (P = NS) between IVIG and controls. In contrast, cytokine elaboration 
      was 60% lower (P < .05) for IVIG versus controls in response to dMLR. One year 
      after renal transplantation, desensitized patients showed in vitro 
      hyporesponsiveness to superantigen and donor-specific challenge. This suggests 
      that IVIG promotes a down-regulation in cellular immunity that may facilitate 
      good graft outcome.
FAU - Kimball, P
AU  - Kimball P
AD  - Department of Transplant Surgery, Medical College of Virginia Hospitals, 
      Richmond, Virginia 23298, USA. pkimball@gems.vcu.edu
FAU - King, A
AU  - King A
LA  - eng
PT  - Journal Article
PL  - United States
TA  - Transplant Proc
JT  - Transplantation proceedings
JID - 0243532
RN  - 0 (Immunoglobulins, Intravenous)
RN  - 0 (Immunologic Factors)
SB  - IM
MH  - Cytotoxicity, Immunologic
MH  - *Desensitization, Immunologic
MH  - Histocompatibility Testing
MH  - Humans
MH  - *Immunity, Cellular
MH  - Immunoglobulins, Intravenous/*therapeutic use
MH  - Immunologic Factors/therapeutic use
MH  - Kidney Transplantation/*immunology
MH  - Living Donors
MH  - Reoperation
EDAT- 2006/12/19 09:00
MHDA- 2007/05/01 09:00
CRDT- 2006/12/19 09:00
PHST- 2006/05/09 00:00 [received]
PHST- 2006/12/19 09:00 [pubmed]
PHST- 2007/05/01 09:00 [medline]
PHST- 2006/12/19 09:00 [entrez]
AID - S0041-1345(06)01401-1 [pii]
AID - 10.1016/j.transproceed.2006.10.155 [doi]
PST - ppublish
SO  - Transplant Proc. 2006 Dec;38(10):3416-7. doi: 10.1016/j.transproceed.2006.10.155.