PMID- 19375474
OWN - NLM
STAT- MEDLINE
DCOM- 20091009
LR  - 20220311
IS  - 1879-1166 (Electronic)
IS  - 0198-8859 (Linking)
VI  - 70
IP  - 8
DP  - 2009 Aug
TI  - Low levels of human leukocyte antigen donor-specific antibodies detected by solid 
      phase assay before transplantation are frequently clinically irrelevant.
PG  - 580-3
LID - 10.1016/j.humimm.2009.04.011 [doi]
AB  - Since new technologies based on solid phase assays (SPA) have been routinely 
      incorporated in the transplant immunology laboratory, the presence of 
      pretransplantation donor-specific antibodies (DSA) against human leukocyte 
      antigen (HLA) molecules has generally been considered as a risk factor for acute 
      rejection (AR) and, in particular, for acute humoral rejection (AHR). We 
      retrospectively studied 113 kidney transplant recipients who had negative 
      prospective T-cell and B-cell complement-dependent cytotoxicity (CDC) 
      crossmatches at the time of transplant. Pretransplantation sera were screened for 
      the presence of circulating anti-HLA antibody and DSA by using highly sensitive 
      and HLA-specific Luminex assay, and the results were correlated with AR and AHR 
      posttransplantation. We found that approximately half of our patient population 
      (55/113, 48.7%) had circulating anti-HLA antibody pretransplantation. Of 113 
      patients, 11 (9.7%) had HLA-DSA. Of 11 rejection episodes post-transplant, only 
      two patients had pretransplantation DSA, of whom one had a severe AHR (C4d 
      positive). One-year allograft survival was similar between the pretransplantation 
      DSA-positive and -negative groups. Number, class, and intensity of 
      pretransplantation DSA, as well as presensitizing events, could not predict AR. 
      We conclude that, based on the presence of pretransplantation DSA, 
      post-transplantation acute rejections episodes could not have been predicted. The 
      only AHR episode occurred in a recipient with pretransplantation DSA. More work 
      should be performed to better delineate the precise clinical significance of 
      detecting low titers of DSA before transplantation.
FAU - Aubert, Vincent
AU  - Aubert V
AD  - Service of Immunology and Allergy, Centre Hospitalier Universitaire Vaudois, 
      Lausanne, Switzerland. vincent.aubert@chuv.ch
FAU - Venetz, Jean-Pierre
AU  - Venetz JP
FAU - Pantaleo, Giuseppe
AU  - Pantaleo G
FAU - Pascual, Manuel
AU  - Pascual M
LA  - eng
PT  - Journal Article
DEP - 20090416
PL  - United States
TA  - Hum Immunol
JT  - Human immunology
JID - 8010936
RN  - 0 (HLA Antigens)
RN  - 0 (Isoantibodies)
SB  - IM
MH  - Adolescent
MH  - Adult
MH  - Aged
MH  - Antibody Formation
MH  - Child
MH  - Child, Preschool
MH  - Female
MH  - Graft Rejection/blood/*diagnosis/*immunology/prevention & control
MH  - HLA Antigens/*immunology
MH  - Humans
MH  - Immunosorbent Techniques
MH  - Isoantibodies/blood/*immunology
MH  - *Kidney Transplantation
MH  - Male
MH  - Microspheres
MH  - Middle Aged
MH  - Predictive Value of Tests
MH  - Prognosis
MH  - Retrospective Studies
MH  - Risk Factors
MH  - *Transplantation Immunology
EDAT- 2009/04/21 09:00
MHDA- 2009/10/10 06:00
CRDT- 2009/04/21 09:00
PHST- 2009/03/10 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)00100-1 [pii]
AID - 10.1016/j.humimm.2009.04.011 [doi]
PST - ppublish
SO  - Hum Immunol. 2009 Aug;70(8):580-3. doi: 10.1016/j.humimm.2009.04.011. Epub 2009 
      Apr 16.