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hla antibodies transplantation

Qiuheng Zhang, Michelle Hickey, Diana Drogalis-Kim, Ying Zheng, David Gjertson, Martin Cadeiras, Tam Khuu, Arnold S Baas, Eugene C Depasquale, Nancy J Halnon, Gregory Perens, Juan Alejos, Daniel Cruz, Nsair Ali, Richard Shemin, Murray Kwon, Michael C Fishbein, Abbas Ardehali, Mario Deng, Elaine F Reed
BACKGROUND: Donor specific HLA antibodies (DSA) are associated with increased rates of rejection and of graft failure in cardiac transplantation. The goal of this study was to determine the association of preformed and posttransplant development of newly detected DSA (ndDSA) with antibody mediated rejection (AMR) and characterize the clinical relevance of complement activating DSA in heart allograft recipients. METHODS: The study included 128 adult and 48 pediatric heart transplant patients transplanted between 2010 to 2013...
June 18, 2018: Transplantation
Guerard W Byrne
The major histocompatibility complex class I and class II human leukocyte antigens (HLA) play a central role in adaptive immunity but are also the dominant polymorphic proteins targeted in allograft rejection. Sensitized patients with high levels of panel-reactive anti-HLA antibody (PRA) are at risk of early allograft injury, rejection, reduced allograft survival and often experience prolonged waiting times prior to transplantation. Xenotransplantation, using genetically modified porcine organs, offers a unique source of donor organs for these highly sensitized patients if the anti-HLA antibody, which places the allograft at risk, does not also enhance anti-pig antibody reactivity responsible for xenograft rejection...
May 2018: Xenotransplantation
Emmanuel Zorn
Innate B cells and natural antibodies (Nabs) have been extensively studied in normal physiological conditions as well as in several diseases. However, their significance in the context of ABO-compatible solid organ transplantation is only emerging. This review summarizes recent studies exploring these often neglected innate immune elements in situations related to sensitization and clinical graft rejection. A focus is placed on class-switched IgG Nabs that develop amidst inflammation, rather than IgM Nabs abundant at the steady state, as new evidence point to their implication in serum reactivity to HLA and kidney graft failure...
May 2018: Xenotransplantation
Albert Y Cheung, Enrica Sarnicola, Khaliq H Kurji, Amit Govil, Gautham Mogilishetty, Medi Eslani, Elizabeth Wright, Paul Brailey, Edward J Holland
PURPOSE: To describe our process for preoperative screening and donor selection for ocular surface stem cell transplantation (OSST). METHODS: A 7-year retrospective chart review was performed on limbal stem cell deficiency patients. The inclusion criterion was all patients who underwent an OSST procedure. The exclusion criterion was eyes with unilateral disease in which an autograft was performed. Data for human leukocyte antigen (HLA) typing, virtual crossmatching, donor-specific antibody, and panel reactive antibody level were obtained...
June 14, 2018: Cornea
Liesbeth Daniëls, Maarten Naesens, Jean-Louis Bosmans, Daniel Abramowicz, Evi Nagler, Steven Van Laecke, Patrick Peeters, Dirk Kuypers, Marie-Paule Emonds
Since the advent of kidney transplantation a key strategy for maximising graft survival by avoiding allorecognition has been to minimise HLA mismatching between donor and recipient. As HLA antibodies are now recognised as being specific for epitopes and donor-recipient HLA mismatch at the amino acid level can now be determined, HLA epitope mismatch load could be a better predictor for dnDSA development than classical HLA antigen mismatch calculation. This hypothesis has been investigated by other studies and the aim of our multicentre study was to confirm this observation in our population...
June 13, 2018: Transplant Immunology
Jonathan Visentin, Lionel Couzi, Claire Dromer, Martine Neau-Cransac, Gwendaline Guidicelli, Vincent Veniard, Karine Nubret-le Coniat, Pierre Merville, Carmelo Di Primo, Jean-Luc Taupin
Human leukocyte antigen (HLA) donor-specific antibodies are key serum biomarkers for assessing the outcome of transplanted patients. Measuring their active concentration, i.e. the fraction that really interacts with donor HLA, and their affinity could help deciphering their pathogenicity. Surface plasmon resonance (SPR) is recognized as the gold-standard for measuring binding kinetics but also active concentrations, without calibration curves. SPR-based biosensors often suffer from non-specific binding (NSB) occurring with the sensor chip surface and the immobilized targets, especially for complex media such as human serum...
June 7, 2018: Biosensors & Bioelectronics
Ming-Rui Huo, Ya-Jing Xu, Shu-Zhen Zhai, Meng Lv, Yu Wang, Le-Qing Cao, Lan-Ping Xu, Xiao-Hui Zhang, Huan Chen, Yu-Hong Chen, Feng-Rong Wang, Wei Han, Yu-Qian Sun, Chen-Hua Yan, Fei-Fei Tang, Xiao-Dong Mo, Ming-Feng Zhao, Kai-Yan Liu, Xiao-Jun Huang, Ying-Jun Chang
We investigated the prevalence of and risk factors for antibodies to HLA in 1,663 haploidentical transplant candidates. Among these cases, 349 (21.0%) showed positive panel-reactive antibody (PRA) either for class I or class II HLA. Multivariate analysis showed the following: i) risk factors associated with the prevalence of PRA either for class I or class II HLA were female gender (P=0.018), prior transfusions (P<0.001) or pregnancy (P<0.001), and cases with MDS (P=0.018); compared to other patients, subjects with ALL had a lower prevalence of class I antibodies (P=0...
June 8, 2018: Human Immunology
M Schmitzer, H Winter, N Kneidinger, G Meimarakis, A Dick, R Schramm, L V Klotz, G Preissler, N Strobl, V von Dossow, C Schneider, T Weig, R Hatz, T Kauke
The impact of de novo donor-specific anti-HLA antibodies (DSA) on outcomes in lung transplantation is still a matter of debate. We hypothesize that differentiating DSA by persistent and transient appearance may offer an additional risk assessment. The clinical relevance of HLA-antibodies was investigated prospectively in 72 recipients with a median follow-up period of 21 months. The presence of HLA-antibodies was analysed by single antigen bead assay prior to and after (3 weeks, 3, 6, 12 and 18 months) transplantation...
June 10, 2018: HLA
Bruce E Gelb, J Rodrigo Diaz-Siso, Natalie M Plana, Adam Jacoby, William J Rifkin, Kimberly S Khouri, Daniel J Ceradini, Eduardo D Rodriguez
Background: Donor-specific antibodies (DSA) to human leukocyte antigen increase the risk of accelerated rejection and allograft damage and reduce the likelihood of successful transplantation. Patients with full-thickness facial burns may benefit from facial allotransplantation. However, they are at a high risk of developing DSA due to standard features of their acute care. Case Presentation: A 41-year-old male with severe disfigurement from facial burns consented to facial allotransplantation in 2014; panel reactive antibody score was 0%...
2018: Case Reports in Transplantation
Alan G Contreras, Aurora Casillas-Abundis, Josefina Alberú, Luis Llorente, Guadalupe Lima, Adriana Arvizu, Adrián de Santiago, Mario Vilatobá, Julio Granados, Luis E Morales-Buenrostro, Rodrigo Cruz, José M Arreola-Guerra
The aim of this study is to compare the association and the predictive capacity of DSA MFI, complement fixing capacity (C3d assay) and IgG subclasses determination in the prediction of FCxM result. METHODS: We used cryopreserved (70C) sera from potential renal transplant recipients, containing DSA against their respective potential donors. All patients showed negative AHG-CDC CxM and either positive or negative FCxM. Class I and Class II HLA-DSA were determined by Luminex SAB. C3d were detected by luminex (Lifecodes®Immucor), DSA IgG 1-4 subclasses were evaluated using monoclonal antibodies specific for IgG subclasses (Luminex)...
June 6, 2018: Transplant Immunology
S Viboon, N Townamchai, S Phiancharoen, P Kupatawintu, V Dhitivat, O Nathalang
BACKGROUND: Non-HLA antibodies specific to angiotensin II type 1 receptor (AT1R-Ab) are associated with antibody-mediated rejection after kidney transplantation. This study aimed to determine the prevalence of AT1R-Ab among pre-transplantation Thai patients and to compare the association of patient demographics with AT1R-Ab levels. METHODS: This cohort study enrolled nonsensitized kidney transplant patients with negative panel reactive antibodies at King Chulalongkorn Memorial Hospital, Bangkok, Thailand...
June 2018: Transplantation Proceedings
K Osickova, A Parikova, J Maluskova, J Fronek, O Viklicky
ABO-incompatible (ABOi) kidney transplantation represents a viable tool to increase the donor pool for kidney transplantation, however, increased alloimmune response has been debated. The early outcomes of 25 low-risk ABOi kidney transplant recipients were compared with thoroughly matched 50 ABO-compatible (ABOc) ones. The matching process was based on gender and age of recipients and immunologic parameters, such as panel reactive antibodies, number of human leukocyte antigen mismatches, and transplantation era...
June 2018: Transplantation Proceedings
K Dziewanowski, M Myślak, R Drozd, E Krzystolik, A Krzystolik, M Ostrowski, M Droździk, K Tejchman, K Kozdroń, J Sieńko
BACKGROUND: Kidney transplantation is a routine procedure in the treatment of patients with kidney failure and requires collaboration of experts from different disciplines. Improvements in the procedure result from numerous factors. METHODS: The analyzed group consisted of 150 patients divided into 2 equal subgroups: long-term (>15 years) and short-term (<6 years) graft survival. The following factors were taken into consideration: graft survival time, HLA mismatches, recipient sex, sex compatibility, panel reactive antibodies (PRA), cold ischemia time (CIT), and cause of kidney insufficiency...
June 2018: Transplantation Proceedings
G Dieplinger, N Mokhaberi, R Wahba, S Peltzer, D Buchner, H A Schlösser, V Ditt, A von Borstel, U Bauerfeind, U Lange, W Arns, C Kurschat, H A Stippel, F Vitinius
BACKGROUND: Pretransplant psychosocial evaluation of living-donor kidney transplantation (LDKT) candidates identifies recipients with potentially inferior posttransplant outcomes. Rating instruments, based on semi-standardized interviews, help to improve and standardize psychosocial evaluation. The goal of this study was to retrospectively investigate the correlation between the Transplant Evaluation Rating Scale (TERS) and transplant outcome in LDKT recipients. METHODS: TERS scores were retrospectively generated by 2 raters based on comprehensive interviews of 146 LDKT recipients conducted by mental health professionals (interrater reliability, 0...
June 2018: Transplantation Proceedings
Kenta Iwasaki, Nana Kitahata, Takahisa Hiramitsu, Takayuki Yamamoto, Takayuki Noda, Manabu Okada, Shunji Narumi, Yoshihiko Watarai, Yuko Miwa, Kazuharu Uchida, Matsuoka Yutaka, Kosei Horimi, Takaaki Kobayashi
It is unclear to what extent follicular helper T-cell (Tfh) development and de novo donor specific HLA antibody (DSA) production could be influenced by immunosuppressive agents, particularly calcineurin inhibitor (CNI), after kidney transplantation. Here, the effects of immunosuppressive agents on Tfh-mediated B-cell activation and antibody production were investigated. In vitro circulating Tfh (cTfh; memory CD4+CXCR5+)/B-cell (CD19+) co-culture assays revealed that CNI considerably inhibited cTfh-mediated B-cell activation and IgG antibody secretion through the suppression of IL-21 and IL-2...
June 7, 2018: International Immunology
Massimo Mangiola, Marilyn Marrari, Christopher Ensor, Martin O Spycher, Mel Berger, Adriana Zeevi
BACKGROUND: Human immunoglobulins (H-Ig) are widely used in solid organ transplantation for IgG replacement and for desensitization and treatment of antibody mediated rejection. They are obtained from plasma pools and may contain HLA antibodies that can be detrimental to transplant recipients. The goal of this study was to evaluate HLA antibodies in multiple lots of 2 commercial H-Ig preparations by. Luminex single antigen bead (SAB) and cell-based crossmatch assays. METHODS: Thirty lots of 2 commercial H-Ig products (CSL Behring, King of Prussia, PA...
June 6, 2018: Transplantation
Jun Nakashima, Hidehiro Itonaga, Machiko Fujioka, Masahiko Chiwata, Yasushi Sawayama, Shunsuke Yoshimura, Hiroshi Iwanaga, Jun Taguchi, Shinichiro Yoshida, Yasushi Miyazaki
A 17-year-old male underwent a second bone marrow transplantation using a 6/8 allele HLA-matched unrelated donor. On day 100 after transplantation, steroid treatment for chronic graft-versus-host disease (GVHD) was started. On day 766, the patient experienced general fatigue, followed by double vision, ptosis, and dysphagia on day 810. Based on the positivity of the acetylcholine receptor antibody and a waning electromyography pattern, he was diagnosed with GVHD-related myasthenia gravis (MG). On day 861, we initiated plasmapheresis (PE), followed by the administration of intravenous immunoglobulin (IVIg) ; this treatment attenuated the bulbar symptoms of MG...
2018: [Rinshō Ketsueki] the Japanese Journal of Clinical Hematology
Paolo Malvezzi, Thomas Jouve, Johan Noble, Lionel Rostaing
The number of kidney transplant candidates is increasing sharply. Among them, at least 20% are HLA sensitized. For these patients, in the setting of both living- and deceased-donor kidney transplant, we may face donor-specific alloantibodies at pretransplant. In such cases, the microlymphocytotoxicity crossmatch may or may not be positive. Kidney transplant with donor-specific antibodies at pretransplant is known as HLA-incompatible transplant. At present, we can use many methods to ensure that the kidney transplant is successful, provided that the recipient is desensitized before or after transplant...
June 1, 2018: Experimental and Clinical Transplantation
Laurie D Snyder, Kathryn J Tinckam
In the rapidly evolving domain of clinical transplantation immunobiology, the interrogation and interpretation of HLA antibodies and their associated clinical consequences are in the spotlight. In lung transplant, HLA antibodies, in particular donor specific antibodies (DSA), are a determining component of the lung transplant antibody mediated rejection (AMR) definition (1). DSA after lung transplant are widely regarded as poor prognosticator, though sparse data to date necessitate ongoing discourse and continued investigation into incidence, timing and treatment...
June 4, 2018: American Journal of Transplantation
Andrej Khandoga, Michael Thomas, Axel Kleespies, Lennart Kühnke, Joachim Andrassy, Antje Habicht, Manfred Stangl, Markus Guba, Martin Angele, Jens Werner, Markus Rentsch
BACKGROUND: Surgical complications following kidney transplantation compromise immediate graft survival. However, the role of early surgical complications in the impairment of long-term survival is not completely established due to various other influences, such as patient comorbidities. The purpose of this study was to characterize the impact of surgical complications and overlapping patient comorbidities on graft function and survival after living donor kidney transplantation (LDKT)...
May 31, 2018: Surgeon: Journal of the Royal Colleges of Surgeons of Edinburgh and Ireland
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