Higgins, Rob, Lowe, David, Hathaway, Mark, Lam, For, Kashi, Habib, Tan, Lam Chin, Imray, C. (Chris), Fletcher, Simon, Chen, Klaus, Krishnan, Nithya, Hamer, Rizwan, Zehnder, Daniel and Briggs, David. (2009) Rises and falls in donor-specific and third-party HLA antibody levels after antibody incompatible transplantation. Transplantation, Vol.87 (No.6). pp. 882-888. ISSN 0041-1337

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Abstract

Background. After human leukocyte antigen (HLA) antibody-incompatible transplantation, donor specific and third party HLA antibodies may be found, and their levels fall in a donor-specific manner during the first month. However, these changes have not been previously described in detail.

Methods. Donor-specific HLA antibody (DSA) and third-party HLA antibody (TPA) levels were measured using the microbead method in 44 presensitized patients who had renal transplantation.

Results. DSA+TPA fell in the first 4 days after transplantation, and greater falls in DSA indicated absorption by the graft. This occurred for class I (57.8% fall compared with 20.2% for TPA, P<0.0005), HLA DR (63.0% vs. 24.3%, P<0.0004), and for HLA DP/DQ/DRB3-4 (34% vs. 17.5%, P=0.014). Peak DSA levels occurred at a mean of 13 days posttransplant, and they were higher than pretreatment in 25 (57%) patients and lower in 19 (43%) patients (P=ns). The risk of rejection was associated with peak DSA levels; 15 of 25 (60%) patients with DSA at median fluorescence intensity (MFI) more than 70000 experienced rejection, compared with 4 of 7 (57%) patients with peak DSA MFI 2000 to 70000, and 2 of 12 (17%) patients with peak DSA MFI less than 20000 (P<0.02). DSA levels subsequently fell in a donor specific manner compared to TPA.

Conclusion. DSA levels may change markedly in the first month after antibody incompatible transplantation, and the risk of rejection was associated with higher pretreatment and peak levels.

Item Type:	Journal Article
Subjects:	Q Science > QR Microbiology > QR180 Immunology R Medicine > RD Surgery
Divisions:	Faculty of Medicine > Warwick Medical School > Translational & Systems Medicine > Metabolic and Vascular Health Faculty of Medicine > Warwick Medical School
Journal or Publication Title:	Transplantation
Publisher:	Lippincott Williams & Wilkins
ISSN:	0041-1337
Official Date:	27 March 2009
Volume:	Vol.87
Number:	No.6
Number of Pages:	7
Page Range:	pp. 882-888
Identification Number:	10.1097/TP.0b013e31819a6788
Status:	Peer Reviewed
Publication Status:	Published
Access rights to Published version:	Restricted or Subscription Access
URI:	http://wrap.warwick.ac.uk/id/eprint/28233

Data sourced from Thomson Reuters' Web of Knowledge

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