PMID- 19375466
OWN - NLM
STAT- MEDLINE
DCOM- 20091009
LR  - 20151119
IS  - 1879-1166 (Electronic)
IS  - 0198-8859 (Linking)
VI  - 70
IP  - 8
DP  - 2009 Aug
TI  - Monitoring and treating posttransplant human leukocyte antigen antibodies.
PG  - 655-9
LID - 10.1016/j.humimm.2009.04.019 [doi]
AB  - The important role of preformed human leukocyte antigen (HLA) antibodies in the 
      outcome of organ transplants has been well demonstrated for the past 40 years. 
      During this same period, the significance of HLA antibody formation after 
      transplantation was largely ignored. Only in the past 10 years has become 
      increasingly clear that HLA antibodies formed posttransplantation are the major 
      cause of allograft failure. We provide here an updated review of the critical 
      evidence implicating HLA antibodies in chronic rejection. It has now also been 
      shown that antibodies formed soon after transplantation are much more toxic to 
      the graft than antibodies formed after the first year. This is likely a result of 
      adaptation of the graft after the first year, possibly through endothelial cell 
      replacement. On the basis of this new finding, a policy of monitoring for 
      antibody development after 3, 6, 9, and 12 months, with yearly checks thereafter, 
      is suggested. Another important new development is the use of bortezomib, a fresh 
      new agent for the removal of antibodies. Because this is the first agent to act 
      on plasma cells, its use is promising. Early data on successful removal of 
      antibodies are reviewed here.
FAU - Everly, Matthew J
AU  - Everly MJ
AD  - Terasaki Foundation, Los Angeles, CA, USA.
FAU - Terasaki, Paul I
AU  - Terasaki PI
LA  - eng
PT  - Journal Article
PT  - Review
DEP - 20090415
PL  - United States
TA  - Hum Immunol
JT  - Human immunology
JID - 8010936
RN  - 0 (Boronic Acids)
RN  - 0 (HLA Antigens)
RN  - 0 (Immunoglobulins, Intravenous)
RN  - 0 (Isoantibodies)
RN  - 0 (Pyrazines)
RN  - 69G8BD63PP (Bortezomib)
RN  - 8N3DW7272P (Cyclophosphamide)
SB  - IM
MH  - Antibody Formation/drug effects
MH  - Boronic Acids/therapeutic use
MH  - Bortezomib
MH  - Cyclophosphamide/therapeutic use
MH  - Graft Rejection/blood/*diagnosis/*immunology/therapy
MH  - HLA Antigens/*immunology
MH  - Humans
MH  - Immunoglobulins, Intravenous/therapeutic use
MH  - Isoantibodies/blood/*immunology
MH  - Monitoring, Physiologic
MH  - *Organ Transplantation
MH  - Plasmapheresis
MH  - Prognosis
MH  - Pyrazines/therapeutic use
MH  - Risk Factors
MH  - *Serologic Tests
MH  - Transplantation
RF  - 86
EDAT- 2009/04/21 09:00
MHDA- 2009/10/10 06:00
CRDT- 2009/04/21 09:00
PHST- 2009/03/02 00:00 [received]
PHST- 2009/04/09 00:00 [accepted]
PHST- 2009/04/21 09:00 [entrez]
PHST- 2009/04/21 09:00 [pubmed]
PHST- 2009/10/10 06:00 [medline]
AID - S0198-8859(09)00108-6 [pii]
AID - 10.1016/j.humimm.2009.04.019 [doi]
PST - ppublish
SO  - Hum Immunol. 2009 Aug;70(8):655-9. doi: 10.1016/j.humimm.2009.04.019. Epub 2009 
      Apr 15.