PMID- 17998862
OWN - NLM
STAT- MEDLINE
DCOM- 20080116
LR  - 20131121
IS  - 0041-1337 (Print)
IS  - 0041-1337 (Linking)
VI  - 84
IP  - 9
DP  - 2007 Nov 15
TI  - The presence of donor-specific human leukocyte antigen antibodies does not 
      preclude successful withdrawal of tacrolimus in stable renal transplant 
      recipients.
PG  - 1092-6
AB  - BACKGROUND: Because of the adverse events associated with the administration of 
      immunosuppressive drugs, reduction of immunosuppression after solid-organ 
      transplantation is highly desirable provided that graft rejection is prevented. 
      In our transplant center, we used an immunosuppression reduction regimen in 
      stable renal transplant patients. The presence of human leukocyte antigen (HLA) 
      antibodies has been negatively associated with transplant outcome. Therefore, we 
      evaluated the impact of HLA antibodies on the occurrence of acute rejection after 
      immunosuppression reduction. METHODS: The presence and antigen specificity of HLA 
      immunoglobulin G antibodies in serum samples were detected using enzyme-linked 
      immunosorbent assay and single-antigen bead assays. Donor-specific cytotoxic 
      potential was tested by standard CDC cross-match analysis. RESULTS: The presence 
      of donor-specific or total HLA antibodies was not predictive for the occurrence 
      of acute rejection after the reduction of immunosuppression. In addition, the 
      presence of HLA antibodies did not preclude successful reduction of 
      immunosuppression. After reduction of immunosuppression, newly formed HLA 
      antibodies were seldom detected. Interestingly, evaluation of the cytotoxic 
      potential of the detected HLA antibodies revealed that the one patient who 
      developed donor-specific HLA antibodies and experienced a subsequent rejection 
      episode was the only patient who carried cytotoxic HLA antibodies. This finding 
      fueled the notion that the functional capacity, rather than the mere presence of 
      donor-specific HLA antibodies, is indicative for transplant outcome. CONCLUSION: 
      The presence of HLA antibodies does not preclude the successful reduction of 
      immunosuppression in renal transplant patients with stable graft function.
FAU - Kreijveld, Ellen
AU  - Kreijveld E
AD  - Department of Blood Transfusion and Transplantation Immunology, Radboud 
      University Medical Centre, Nijmegen, the Netherlands.
FAU - Hilbrands, Luuk B
AU  - Hilbrands LB
FAU - van Berkel, Yvonne
AU  - van Berkel Y
FAU - Joosten, Irma
AU  - Joosten I
FAU - Allebes, Wil
AU  - Allebes W
LA  - eng
PT  - Journal Article
PL  - United States
TA  - Transplantation
JT  - Transplantation
JID - 0132144
RN  - 0 (HLA Antigens)
RN  - 0 (HLA-D Antigens)
RN  - 0 (Histocompatibility Antigens Class I)
RN  - 0 (Immunoglobulin G)
RN  - 9007-36-7 (Complement System Proteins)
RN  - AYI8EX34EU (Creatinine)
SB  - IM
MH  - Complement System Proteins/immunology
MH  - Creatinine/blood
MH  - HLA Antigens/blood/*immunology
MH  - HLA-D Antigens/classification
MH  - Histocompatibility Antigens Class I/classification
MH  - Histocompatibility Testing
MH  - Humans
MH  - Immunoglobulin G/blood
MH  - Kidney Transplantation/*immunology
MH  - *Tissue Donors
MH  - Transplantation, Homologous
MH  - Treatment Outcome
EDAT- 2007/11/14 09:00
MHDA- 2008/01/17 09:00
CRDT- 2007/11/14 09:00
PHST- 2007/11/14 09:00 [pubmed]
PHST- 2008/01/17 09:00 [medline]
PHST- 2007/11/14 09:00 [entrez]
AID - 00007890-200711150-00005 [pii]
AID - 10.1097/01.tp.0000285994.29305.b1 [doi]
PST - ppublish
SO  - Transplantation. 2007 Nov 15;84(9):1092-6. doi: 
      10.1097/01.tp.0000285994.29305.b1.