PMID- 27512872
OWN - NLM
STAT- MEDLINE
DCOM- 20170206
LR  - 20210109
IS  - 1536-5964 (Electronic)
IS  - 0025-7974 (Print)
IS  - 0025-7974 (Linking)
VI  - 95
IP  - 32
DP  - 2016 Aug
TI  - Successful kidney transplantation after desensitization in a patient with 
      positive flow crossmatching and donor-specific anti-HLA-DP antibody: A Case 
      report.
PG  - e4521
LID - 10.1097/MD.0000000000004521 [doi]
LID - e4521
AB  - BACKGROUND: Traditionally, the presence of antibodies against human leukocyte 
      antigen (HLA)-C and DP was considered to be associated with only a low risk of 
      antibody-mediated rejection (ABMR) in kidney transplantation (KT), because the 
      antigenicities of these proteins are weak. However, the clinical effects of HLA-C 
      and -DP donor-specific HLA antibodies (DSHAs) have recently been reevaluated. 
      METHODS: Here, we report the case of a retransplant patient with positive flow 
      cytometry crossmatch (FCXM) and high level of HLA-DP DSHA who was desensitized 
      using rituximab, plasmapheresis, and intravenous immunoglobulin. RESULTS: The 
      epitope-based antibody reactivity was identified that the positive B-cell FCXM in 
      our patient was attributable to the specific epitope. The patient underwent a 
      successful retransplantation and has continued to do well for 10 month after KT. 
      CONCLUSION: If an HLA-DP DSHA is present, it is important to detect any 
      mismatched HLA-DP epitope pretransplantation and to monitor HLA-DP levels 
      carefully. According to previous reports, anti-HLA-DP DSHA can induce ABMR soon 
      after transplantation, but such ABMR can be prevented by pretransplantation 
      desensitization and careful monitoring of DSHA levels.
FAU - Song, Seung Hwan
AU  - Song SH
AD  - Department of Transplant Surgery Department of Laboratory Medicine, Severance 
      Hospital, Yonsei University College of Medicine, Seoul, South Korea.
FAU - Park, Borae G
AU  - Park BG
FAU - Lee, Juhan
AU  - Lee J
FAU - Kim, Myoung Soo
AU  - Kim MS
FAU - Kim, Yu Seun
AU  - Kim YS
FAU - Kim, Hyon-Suk
AU  - Kim HS
LA  - eng
PT  - Case Reports
PT  - Journal Article
PL  - United States
TA  - Medicine (Baltimore)
JT  - Medicine
JID - 2985248R
RN  - 0 (Antibodies, Anti-Idiotypic)
RN  - 0 (HLA-DP Antigens)
SB  - IM
MH  - Adult
MH  - Antibodies, Anti-Idiotypic/*immunology
MH  - Blood Grouping and Crossmatching/*methods
MH  - Desensitization, Immunologic/*methods
MH  - Female
MH  - Flow Cytometry
MH  - HLA-DP Antigens/*immunology
MH  - Humans
MH  - Kidney Transplantation/*methods
PMC - PMC4985327
COIS- The authors have no funding and conflicts of interest to disclose.
EDAT- 2016/08/12 06:00
MHDA- 2017/02/07 06:00
PMCR- 2016/08/12
CRDT- 2016/08/12 06:00
PHST- 2016/08/12 06:00 [entrez]
PHST- 2016/08/12 06:00 [pubmed]
PHST- 2017/02/07 06:00 [medline]
PHST- 2016/08/12 00:00 [pmc-release]
AID - 00005792-201608090-00038 [pii]
AID - 10.1097/MD.0000000000004521 [doi]
PST - ppublish
SO  - Medicine (Baltimore). 2016 Aug;95(32):e4521. doi: 10.1097/MD.0000000000004521.