PMID- 19300192
OWN - NLM
STAT- MEDLINE
DCOM- 20090514
LR  - 20220321
IS  - 1534-6080 (Electronic)
IS  - 0041-1337 (Linking)
VI  - 87
IP  - 6
DP  - 2009 Mar 27
TI  - Rises and falls in donor-specific and third-party HLA antibody levels after 
      antibody incompatible transplantation.
PG  - 882-8
LID - 10.1097/TP.0b013e31819a6788 [doi]
AB  - BACKGROUND: After human leukocyte antigen (HLA) antibody-incompatible 
      transplantation, donor specific and third party HLA antibodies may be found, and 
      their levels fall in a donor-specific manner during the first month. However, 
      these changes have not been previously described in detail. METHODS: 
      Donor-specific HLA antibody (DSA) and third-party HLA antibody (TPA) levels were 
      measured using the microbead method in 44 presensitized patients who had renal 
      transplantation. RESULTS: DSA+TPA fell in the first 4 days after transplantation, 
      and greater falls in DSA indicated absorption by the graft. This occurred for 
      class I (57.8% fall compared with 20.2% for TPA, P<0.0005), HLA DR (63.0% vs. 
      24.3%, P<0.0004), and for HLA DP/DQ/DRB3-4 (34% vs. 17.5%, P=0.014). Peak DSA 
      levels occurred at a mean of 13 days posttransplant, and they were higher than 
      pretreatment in 25 (57%) patients and lower in 19 (43%) patients (P=ns). The risk 
      of rejection was associated with peak DSA levels; 15 of 25 (60%) patients with 
      DSA at median fluorescence intensity (MFI) more than 7000U experienced rejection, 
      compared with 4 of 7 (57%) patients with peak DSA MFI 2000 to 7000U, and 2 of 12 
      (17%) patients with peak DSA MFI less than 2000U (P<0.02). DSA levels 
      subsequently fell in a donor specific manner compared to TPA. CONCLUSION: DSA 
      levels may change markedly in the first month after antibody incompatible 
      transplantation, and the risk of rejection was associated with higher 
      pretreatment and peak levels.
FAU - Higgins, Rob
AU  - Higgins R
AD  - Transplant Unit, University Hospitals Coventry and Warwickshire, Coventry, West 
      Midlands, United Kingdom. Robert.Higgins@uhcw.nhs.uk
FAU - Lowe, David
AU  - Lowe D
FAU - Hathaway, Mark
AU  - Hathaway M
FAU - Lam, For
AU  - Lam F
FAU - Kashi, Habib
AU  - Kashi H
FAU - Tan, Lam Chin
AU  - Tan LC
FAU - Imray, Chris
AU  - Imray C
FAU - Fletcher, Simon
AU  - Fletcher S
FAU - Chen, Klaus
AU  - Chen K
FAU - Krishnan, Nithya
AU  - Krishnan N
FAU - Hamer, Rizwan
AU  - Hamer R
FAU - Zehnder, Daniel
AU  - Zehnder D
FAU - Briggs, David
AU  - Briggs D
LA  - eng
PT  - Journal Article
PT  - Multicenter Study
PL  - United States
TA  - Transplantation
JT  - Transplantation
JID - 0132144
RN  - 0 (HLA Antigens)
RN  - 0 (HLA-DR Antigens)
RN  - 0 (Immunosuppressive Agents)
RN  - 0 (Isoantibodies)
RN  - 9PHQ9Y1OLM (Prednisolone)
RN  - HU9DX48N0T (Mycophenolic Acid)
RN  - WM0HAQ4WNM (Tacrolimus)
SB  - IM
MH  - Blood Group Incompatibility/*immunology
MH  - Female
MH  - Graft Rejection/immunology
MH  - HLA Antigens/*immunology
MH  - HLA-DR Antigens/immunology
MH  - Histocompatibility Testing/methods
MH  - Humans
MH  - Immunosuppressive Agents/therapeutic use
MH  - Isoantibodies/*immunology
MH  - Kidney Transplantation/*immunology
MH  - Living Donors/statistics & numerical data
MH  - Male
MH  - Mycophenolic Acid/analogs & derivatives/therapeutic use
MH  - Prednisolone/therapeutic use
MH  - Tacrolimus/therapeutic use
EDAT- 2009/03/21 09:00
MHDA- 2009/05/15 09:00
CRDT- 2009/03/21 09:00
PHST- 2009/03/21 09:00 [entrez]
PHST- 2009/03/21 09:00 [pubmed]
PHST- 2009/05/15 09:00 [medline]
AID - 00007890-200903270-00015 [pii]
AID - 10.1097/TP.0b013e31819a6788 [doi]
PST - ppublish
SO  - Transplantation. 2009 Mar 27;87(6):882-8. doi: 10.1097/TP.0b013e31819a6788.