PMID- 24279605
OWN - NLM
STAT- MEDLINE
DCOM- 20150511
LR  - 20211203
IS  - 1432-2277 (Electronic)
IS  - 0934-0874 (Linking)
VI  - 27
IP  - 3
DP  - 2014 Mar
TI  - Clinical relevance of the de novo production of anti-HLA antibodies following 
      intestinal and multivisceral transplantation.
PG  - 280-9
LID - 10.1111/tri.12250 [doi]
AB  - Despite a negative pretransplant cross-match, intestinal transplant recipients 
      can mount humoral immune responses soon after transplantation. Moreover, the 
      development of donor-specific anti-HLA antibodies (DSAs) is associated with 
      severe graft injury. Between June 2000 and August 2011, 30 patients (median age 
      37.6+/-9.8 years) received isolated intestinal transplantations (ITX, n=18) or 
      multivisceral transplantations (MVTXs, n=12) at our center. We screened for human 
      leukocyte antigen (HLA) antibodies pre- and post-transplant. If patients produced 
      DSAs, treatment with plasmapheresis and intravenous immunoglobulin (IVIG) was 
      initiated. In the event of DSA persistence and/or treatment-refractory rejection, 
      rituximab and/or bortezomib were added. Ten patients developed DSAs and 
      simultaneously showed significant signs of rejection. These patients received 
      plasmapheresis and IVIG. Eight patients additionally received rituximab, and two 
      patients were treated with bortezomib. DSA values decreased upon antirejection 
      therapy in 8 of the 10 patients. The development of DSAs following ITX is often 
      associated with acute rejection. We observed that the number of mismatched 
      antigens and epitopes correlates with the probability of developing de novo DSAs. 
      Early diagnosis and therapy, including B-cell depletion and plasma cell 
      inhibition, are crucial to preventing further graft injury.
CI  - (c) 2013 Steunstichting ESOT.
FAU - Gerlach, Undine A
AU  - Gerlach UA
AD  - Department of General, Visceral and Transplantation Surgery, Campus Virchow 
      Klinikum, Charite-Universitatsmedizin Berlin, Berlin, Germany.
FAU - Lachmann, Nils
AU  - Lachmann N
FAU - Sawitzki, Birgit
AU  - Sawitzki B
FAU - Arsenic, Ruza
AU  - Arsenic R
FAU - Neuhaus, Peter
AU  - Neuhaus P
FAU - Schoenemann, Constanze
AU  - Schoenemann C
FAU - Pascher, Andreas
AU  - Pascher A
LA  - eng
PT  - Journal Article
DEP - 20140116
PL  - Switzerland
TA  - Transpl Int
JT  - Transplant international : official journal of the European Society for Organ 
      Transplantation
JID - 8908516
RN  - 0 (HLA Antigens)
RN  - 0 (Isoantibodies)
SB  - IM
MH  - Adult
MH  - Antibody Specificity
MH  - Female
MH  - Graft Rejection/etiology/immunology/therapy
MH  - HLA Antigens/*immunology
MH  - Humans
MH  - Immunosuppression Therapy/methods
MH  - Intestines/immunology/pathology/*transplantation
MH  - Isoantibodies/*biosynthesis
MH  - Male
MH  - Middle Aged
MH  - Tissue Donors
MH  - *Transplantation Immunology
MH  - Young Adult
OTO - NOTNLM
OT  - Antibody-mediated rejection
OT  - donor-specific anti-HLA antibodies
OT  - intestine
OT  - multivisceral clinical
EDAT- 2013/11/28 06:00
MHDA- 2015/05/12 06:00
CRDT- 2013/11/28 06:00
PHST- 2013/09/18 00:00 [received]
PHST- 2013/10/20 00:00 [revised]
PHST- 2013/11/23 00:00 [accepted]
PHST- 2013/11/28 06:00 [entrez]
PHST- 2013/11/28 06:00 [pubmed]
PHST- 2015/05/12 06:00 [medline]
AID - 10.1111/tri.12250 [doi]
PST - ppublish
SO  - Transpl Int. 2014 Mar;27(3):280-9. doi: 10.1111/tri.12250. Epub 2014 Jan 16.