PMID- 31896922
OWN - NLM
STAT- PubMed-not-MEDLINE
LR  - 20201001
IS  - 0973-6247 (Print)
IS  - 1998-3565 (Electronic)
IS  - 0973-6247 (Linking)
VI  - 13
IP  - 2
DP  - 2019 Jul-Dec
TI  - Role of de novo DQ donor-specific antibody in antibody-mediated rejection in 
      renal transplant recipient: A case study.
PG  - 136-139
LID - 10.4103/ajts.AJTS_1_18 [doi]
AB  - The human leukocyte antigen (HLA) matching plays an important role in determining 
      the clinical outcome of renal transplantation. The development of donor specific 
      antibodies (DSA) against HLA is associated with antibody mediated allograft 
      tissue injury, poor outcome and rejection. The DQ-DSA develops in a denovo 
      pattern and its unfavorable impact on renal transplantation has not yet been 
      widely reported. We investigated the clinical significance of DQ-DSA in a patient 
      diagnosed with hypertension, CKD stage V on maintenance hemodialysis (MHD) for 
      second renal transplant. The histocompatibility workup before the first 
      transplant included low resolution HLA-A, B, DR typing of both patient and donor. 
      HLA type of the patient was HLA-A*29, 68, HLAB*44, 44, DRB1*07, 11. HLA type of 
      the donor was HLA-A*03, 68, HLA-B*39, 44, DRB1*07, 10 with a 3/6 match. The HLA 
      antibody screen and complement dependent cytotoxicity crossmatch (CDC) were found 
      to be negative. No therapeutic plasma exchanges (TPE) were done during stay and 
      post-transplant the patient was on triple immunosuppressant therapy. After four 
      years the patient was diagnosed with recurrent membranoproliferative 
      glomerulonephritis and second renal transplant was planned, therefore, 
      histocompatibility workup was initiated. HLA antibody screen was found to be 
      positive for HLA class II. Initially only HLA-A, B, DR typing was performed and 
      that too only low resolution, further, high resolution HLA typing was done for 
      HLA-DR and DQ to rule out if these antibodies are de-novo DQ/DR DSA. We analyzed 
      that the patient had developed de-novo DSA against HLA-DRB1* 10:01 (DR10), 
      MFI-2374 and DQB1*06:01 (DQ6), MFI-15315. This study suggests the role of DQ 
      antibodies in determining the graft survival and to highlight the need of HLA DQ 
      typing as a routine of the diagnostic work-up in a solid organ transplant.
CI  - Copyright: (c) 2019 Asian Journal of Transfusion Science.
FAU - Chowdhry, Mohit
AU  - Chowdhry M
AD  - Department of Transfusion Medicine, Indraprastha Apollo Hospital, New Delhi, 
      India.
FAU - Patel, Manthan
AU  - Patel M
AD  - Department of Transfusion Medicine, Indraprastha Apollo Hospital, New Delhi, 
      India.
FAU - Thakur, Yogita
AU  - Thakur Y
AD  - Department of Transfusion Medicine, Indraprastha Apollo Hospital, New Delhi, 
      India.
FAU - Sharma, Vandana
AU  - Sharma V
AD  - Department of Transfusion Medicine, Indraprastha Apollo Hospital, New Delhi, 
      India.
LA  - eng
PT  - Case Reports
DEP - 20191203
PL  - India
TA  - Asian J Transfus Sci
JT  - Asian journal of transfusion science
JID - 101306858
PMC - PMC6910037
OTO - NOTNLM
OT  - Complement-dependent cytotoxicity crossmatch
OT  - de novo donor-specific antibodies
OT  - donor-specific antibodies
OT  - human leukocyte antigen
COIS- There are no conflicts of interest.
EDAT- 2020/01/04 06:00
MHDA- 2020/01/04 06:01
PMCR- 2019/07/01
CRDT- 2020/01/04 06:00
PHST- 2018/01/06 00:00 [received]
PHST- 2018/05/15 00:00 [accepted]
PHST- 2020/01/04 06:00 [entrez]
PHST- 2020/01/04 06:00 [pubmed]
PHST- 2020/01/04 06:01 [medline]
PHST- 2019/07/01 00:00 [pmc-release]
AID - AJTS-13-136 [pii]
AID - 10.4103/ajts.AJTS_1_18 [doi]
PST - ppublish
SO  - Asian J Transfus Sci. 2019 Jul-Dec;13(2):136-139. doi: 10.4103/ajts.AJTS_1_18. 
      Epub 2019 Dec 3.