Low levels of human leukocyte antigen donor-specific antibodies detected by solid phase assay before transplantation are frequently clinically irrelevant.

Détails

ID Serval
serval:BIB_C112FB3AA6A4
Type
Article: article d'un périodique ou d'un magazine.
Collection
Publications
Titre
Low levels of human leukocyte antigen donor-specific antibodies detected by solid phase assay before transplantation are frequently clinically irrelevant.
Périodique
Human Immunology
Auteur(s)
Aubert V., Venetz J.P., Pantaleo G., Pascual M.
ISSN
1879-1166[electronic]
Statut éditorial
Publié
Date de publication
2009
Volume
70
Numéro
8
Pages
580-583
Langue
anglais
Résumé
Since new technologies based on solid phase assays (SPA) have been routinely incorporated in the transplant immunology laboratory, the presence of pretransplantation donor-specific antibodies (DSA) against human leukocyte antigen (HLA) molecules has generally been considered as a risk factor for acute rejection (AR) and, in particular, for acute humoral rejection (AHR). We retrospectively studied 113 kidney transplant recipients who had negative prospective T-cell and B-cell complement-dependent cytotoxicity (CDC) crossmatches at the time of transplant. Pretransplantation sera were screened for the presence of circulating anti-HLA antibody and DSA by using highly sensitive and HLA-specific Luminex assay, and the results were correlated with AR and AHR posttransplantation. We found that approximately half of our patient population (55/113, 48.7%) had circulating anti-HLA antibody pretransplantation. Of 113 patients, 11 (9.7%) had HLA-DSA. Of 11 rejection episodes post-transplant, only two patients had pretransplantation DSA, of whom one had a severe AHR (C4d positive). One-year allograft survival was similar between the pretransplantation DSA-positive and -negative groups. Number, class, and intensity of pretransplantation DSA, as well as presensitizing events, could not predict AR. We conclude that, based on the presence of pretransplantation DSA, post-transplantation acute rejections episodes could not have been predicted. The only AHR episode occurred in a recipient with pretransplantation DSA. More work should be performed to better delineate the precise clinical significance of detecting low titers of DSA before transplantation.
Mots-clé
Adolescent, Adult, Aged, Antibody Formation, Child, Child, Preschool, Female, Graft Rejection/blood, Graft Rejection/diagnosis, HLA Antigens/immunology, Humans, Immunosorbent Techniques, Isoantibodies/blood, Isoantibodies/immunology, Kidney Transplantation, Male, Microspheres, Middle Aged, Predictive Value of Tests, Prognosis, Retrospective Studies, Risk Factors, Transplantation Immunology
Pubmed
Web of science
Création de la notice
30/10/2009 16:29
Dernière modification de la notice
20/08/2019 15:35
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