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Rises and falls in donor-specific and third-party HLA antibody levels after antibody incompatible transplantation
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Higgins, Rob, Lowe, David Philip, 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. doi:10.1097/TP.0b013e31819a6788 ISSN 0041-1337.
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Official URL: http://dx.doi.org/10.1097/TP.0b013e31819a6788
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 |
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| Divisions: | Faculty of Science, Engineering and Medicine > Medicine > Warwick Medical School > Biomedical Sciences > Translational & Experimental Medicine > Metabolic and Vascular Health (- until July 2016) Faculty of Science, Engineering and Medicine > Medicine > Warwick Medical School |
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| Journal or Publication Title: | Transplantation | ||||
| Publisher: | Lippincott Williams & Wilkins | ||||
| ISSN: | 0041-1337 | ||||
| Official Date: | 27 March 2009 | ||||
| Dates: |
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| Volume: | Vol.87 | ||||
| Number: | No.6 | ||||
| Number of Pages: | 7 | ||||
| Page Range: | pp. 882-888 | ||||
| DOI: | 10.1097/TP.0b013e31819a6788 | ||||
| Status: | Peer Reviewed | ||||
| Publication Status: | Published | ||||
| Access rights to Published version: | Restricted or Subscription Access |
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