Article: article from journal or magazin.
Prevalence and significance of anti-HLA and donor-specific antibodies long-term after renal transplantation.
Publication types: Journal Article ; Research Support, Non-U.S. Gov't
Post-transplant circulating anti-human leukocyte antigens (HLA)-antibodies and C4d in allograft biopsies may be important in chronic rejection in renal transplant recipients (RTR). We determined the prevalence and significance of anti-HLA-antibodies and donor-specific antibodies (DSA). Sera were collected from 251 RTR >6 months post-transplant. Sera were tested using enzyme-linked immunosorbent assay (ELISA) screening for anti-HLA antibodies. Positive sera were retested with ELISA-specific panel for antibody specificity. A 11.2% of patients had anti-HLA antibodies and 4.4% had DSA. Anti-HLA antibodies were significantly associated with pretransplant sensitization, acute rejection and in multivariate analysis, higher serum creatinine (2.15 +/- 0.98 vs. 1.57 +/- 0.69 mg/dl in negative anti-HLA antibodies group). Allograft biopsies performed in a subset of patients with anti-HLA antibodies revealed that 66% had C4d in peritubular capillaries (0% in patients without antibodies). Anti-HLA antibodies were associated with a worse allograft function and in situ evidence of anti-donor humoral alloreactivity. Long-term RTR with an increase in creatinine could be screened for anti-HLA antibodies and C4d in biopsy.
Adolescent, Adult, Aged, Aged, 80 and over, Antibody Specificity, Child, Child, Preschool, Chronic Disease, Complement C4b/metabolism, Cross-Sectional Studies, Female, Graft Rejection/etiology, Graft Rejection/immunology, HLA Antigens/immunology, Humans, Isoantibodies/blood, Kidney Transplantation/adverse effects, Kidney Transplantation/immunology, Male, Middle Aged, Peptide Fragments/metabolism, Time Factors, Tissue Donors
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