PMID- 19623018
OWN - NLM
STAT- MEDLINE
DCOM- 20090916
LR  - 20090722
IS  - 1534-6080 (Electronic)
IS  - 0041-1337 (Linking)
VI  - 88
IP  - 2
DP  - 2009 Jul 27
TI  - Intact HLA not beta2m-free heavy chain-specific HLA class I antibodies are 
      predictive of graft failure.
PG  - 226-30
LID - 10.1097/TP.0b013e3181ac6198 [doi]
AB  - BACKGROUND: We investigated the effects of intact and beta2m-free heavy chain 
      (HC)-specific human leukocyte antigen (HLA) class I antibodies on long-term graft 
      survival. METHODS: HLA class I mixed antigen beads were used to detect intact and 
      beta2m-free HC-specific antibodies, whereas elution buffer-treated beads were 
      used to detect antibodies against beta2m-free HC. Donor-specific antibodies 
      (DSAs) were identified using single-antigen beads. Complement-dependent 
      cytotoxicity assays were performed to determine the cytotoxicity of DSA. RESULTS: 
      Three hundred seventy-nine of 994 of patients (38%) had antibodies against intact 
      HLA and beta2m-free HC. There was no survival rate difference between 
      antibody-positive and -negative groups. When the 379 antibody-positive patients 
      were further tested with beta2m-free HC-coated beads, 179 of them with antibodies 
      only against intact form of antigens had a 4-year graft survival rate of 76%, 
      which is significantly lower than that of 200 patients with antibodies against 
      beta2m-free HC of HLA antigens (88%, P=0.0056). Patients with intact antigen 
      specific DSAs had a significantly lower graft survival rate as compared with 
      those with no DSAs (70% vs. 89%, P=0.0073). More patients with strong 
      donor-specific cytotoxic antibodies lost allografts than those with 
      weak-cytotoxic or noncytotoxic antibodies. However, cytotoxic activity of DSA was 
      not correlated to antibody level. CONCLUSIONS: We concluded that intact 
      antigen-specific antibodies, especially DSAs, are predictive of graft failure. 
      DSAs were not always cytotoxic. Strong cytotoxic activity of DSA was associated 
      with a higher rate of graft loss but not correlated to the antibody level. 
      Antibodies against beta2m-free HC negatively interfere with the predictive value 
      of intact antigen-specific antibodies.
FAU - Cai, Junchao
AU  - Cai J
AD  - Terasaki Foundation Laboratory, Los Angeles, CA, USA. terasaki@terasakilab.org
FAU - Terasaki, Paul I
AU  - Terasaki PI
FAU - Anderson, Naomi
AU  - Anderson N
FAU - Lachmann, Nils
AU  - Lachmann N
FAU - Schonemann, Constanze
AU  - Schonemann C
LA  - eng
PT  - Journal Article
PL  - United States
TA  - Transplantation
JT  - Transplantation
JID - 0132144
RN  - 0 (Autoantibodies)
RN  - 0 (HLA Antigens)
RN  - 0 (Histocompatibility Antigens Class I)
RN  - 0 (Immunoglobulin Heavy Chains)
RN  - 0 (Isoantibodies)
SB  - IM
MH  - Adult
MH  - Autoantibodies/immunology
MH  - Female
MH  - Graft Rejection/*immunology
MH  - Graft Survival/*immunology
MH  - HLA Antigens/immunology
MH  - Histocompatibility Antigens Class I/*immunology
MH  - Humans
MH  - Immunoglobulin Heavy Chains/immunology
MH  - Isoantibodies/immunology
MH  - Kidney Transplantation/*immunology
MH  - Male
MH  - Middle Aged
MH  - Predictive Value of Tests
MH  - Retrospective Studies
MH  - Transplantation, Homologous/immunology
MH  - Treatment Failure
EDAT- 2009/07/23 09:00
MHDA- 2009/09/17 06:00
CRDT- 2009/07/23 09:00
PHST- 2009/07/23 09:00 [entrez]
PHST- 2009/07/23 09:00 [pubmed]
PHST- 2009/09/17 06:00 [medline]
AID - 00007890-200907270-00012 [pii]
AID - 10.1097/TP.0b013e3181ac6198 [doi]
PST - ppublish
SO  - Transplantation. 2009 Jul 27;88(2):226-30. doi: 10.1097/TP.0b013e3181ac6198.