PMID- 21888935
OWN - NLM
STAT- MEDLINE
DCOM- 20120206
LR  - 20111017
IS  - 1879-1166 (Electronic)
IS  - 0198-8859 (Linking)
VI  - 72
IP  - 11
DP  - 2011 Nov
TI  - Heart transplantation with donor-specific antibodies directed toward denatured 
      HLA-A*02:01: a case report.
PG  - 1045-8
LID - 10.1016/j.humimm.2011.08.001 [doi]
AB  - The development of solid-phase assays for antibody detection has aided in the 
      frequent detection of human leukocyte antigen (HLA) antibodies in 
      nonalloimmunized males. Some scientists have reported that these HLA antibodies 
      are produced to pathogens or allergens and the reactivity with HLA coated beads 
      is the result of cross-reactive epitopes. These antibodies may also be directed 
      toward cryptic epitopes exposed on the denatured beads. In this report, we 
      describe the case of a heart transplanted patient who exhibited anti-HLA-A*02:01 
      donor-specific antibodies detected with a bead-based assay (Luminex) and 
      undetected with the complement-dependent cytotoxicity (CDC) test. Posttransplant 
      monitoring, carried out with CDC and with Luminex on sera from this patient 
      collected at the 2nd, 4th, 8th, and 12th posttransplant weeks and at 1 year 
      confirmed the presence of anti-HLA-A*02:01 in all serum samples. Additional tests 
      carried out with denatured and intact HLA molecules using single antigen beads 
      demonstrated that the antibody was directed toward a cryptic epitope. One year 
      after transplantation the patient is doing well. No sign of antibody-mediated 
      rejection was observed throughout the follow-up. A comprehensive evaluation of 
      the anamnesis and of antibodies is critical to avoid needless exclusion of organ 
      donors.
CI  - Copyright (c) 2011 American Society for Histocompatibility and Immunogenetics. 
      Published by Elsevier Inc. All rights reserved.
FAU - Poli, Francesca
AU  - Poli F
AD  - Organ and Tissue Transplantation Immunology, Fondazione IRCCS Ca' Granda Ospedale 
      Maggiore Policlinico, 20122 Milan, Italy. france.poli@policlinico.mi.it
FAU - Benazzi, Elena
AU  - Benazzi E
FAU - Innocente, Annalisa
AU  - Innocente A
FAU - Nocco, Angela
AU  - Nocco A
FAU - Cagni, Nicoletta
AU  - Cagni N
FAU - Gianatti, Andrea
AU  - Gianatti A
FAU - Fiocchi, Roberto
AU  - Fiocchi R
FAU - Scalamogna, Mario
AU  - Scalamogna M
LA  - eng
PT  - Case Reports
PT  - Journal Article
DEP - 20110810
PL  - United States
TA  - Hum Immunol
JT  - Human immunology
JID - 8010936
RN  - 0 (Epitopes)
RN  - 0 (HLA-A*02:01 antigen)
RN  - 0 (HLA-A2 Antigen)
RN  - 0 (Isoantibodies)
SB  - IM
MH  - Antibody-Dependent Cell Cytotoxicity
MH  - Cardiomyopathy, Dilated/blood/genetics/immunology/*therapy
MH  - Disease-Free Survival
MH  - Epitopes/immunology/*metabolism
MH  - Flow Cytometry
MH  - Graft Survival
MH  - HLA-A2 Antigen/immunology/*metabolism
MH  - *Heart Transplantation
MH  - Histocompatibility Testing
MH  - Humans
MH  - Isoantibodies/*blood
MH  - Male
MH  - Middle Aged
MH  - Monitoring, Physiologic
MH  - Protein Denaturation
EDAT- 2011/09/06 06:00
MHDA- 2012/02/07 06:00
CRDT- 2011/09/06 06:00
PHST- 2011/06/10 00:00 [received]
PHST- 2011/07/29 00:00 [revised]
PHST- 2011/08/04 00:00 [accepted]
PHST- 2011/09/06 06:00 [entrez]
PHST- 2011/09/06 06:00 [pubmed]
PHST- 2012/02/07 06:00 [medline]
AID - S0198-8859(11)00490-3 [pii]
AID - 10.1016/j.humimm.2011.08.001 [doi]
PST - ppublish
SO  - Hum Immunol. 2011 Nov;72(11):1045-8. doi: 10.1016/j.humimm.2011.08.001. Epub 2011 
      Aug 10.