scholarly journals Clinical Case: Patient with Mixed Graft Rejection Four Days after Kidney Transplantation Developed Specific Antibodies against Donor Bw4 Specificities

Antibodies ◽  
2021 ◽  
Vol 10 (3) ◽  
pp. 28
Author(s):  
Claudia M. Muñoz-Herrera ◽  
Juan Francisco Gutiérrez-Bautista ◽  
Miguel Ángel López-Nevot
Keyword(s):  
Kidney Transplantation ◽  
Graft Rejection ◽  
Human Leukocyte ◽  
Case Patient ◽  
Specific Antibodies ◽  
Antibody Mediated Rejection ◽  
Leukocyte Antigens ◽  
Hla Genotypes ◽  
Donor Specific Antibodies ◽  
Hla Genotype

Kidney transplantation, like other transplants, has the risk of producing graft rejection due to genetic differences between donor and recipient. The three known types of renal rejection are listed in the Banff classification: T-cell-mediated rejection (TCMR), antibody-mediated rejection (ABMR), and mixed rejection. The human leukocyte antigens (HLA) are highly polymorphic and may be the targets of donor-specific antibodies, resulting in ABMR. Therefore, prior to transplantation, it is necessary to analyze the HLA genotype of the donor and recipient, as well as the presence of DSA, in order to avoid hyperacute rejection. However, due to the shortage of kidneys, it is very difficult to find a donor and a recipient with completely matched HLA genotypes. This can trigger a future rejection of the kidney, as is reported in this work. We describe a patient who received a kidney transplant after a negative DSA test, who developed graft rejection with antibodies against the donor’s HLA-Bw4 public epitope and lymphocytic infiltrate four days after transplantation, whose differential diagnosis was mixed rejection.

scholarly journals Combined Liver-Kidney Transplantation With Preformed Anti–human Leukocyte Antigen Donor-Specific Antibodies

2020 ◽  
Vol 5 (12) ◽  
pp. 2202-2211
Author(s):  
Arnaud Del Bello ◽  
Olivier Thaunat ◽  
Moglie Le Quintrec ◽  
Oriol Bestard ◽  
Antoine Durrbach ◽  
...  
Keyword(s):  
Kidney Transplantation ◽  
Human Leukocyte Antigen ◽  
Human Leukocyte ◽  
Specific Antibodies ◽  
Leukocyte Antigen ◽  
Donor Specific Antibodies

scholarly journals Intensity of de novo DSA detected by Immucor Lifecodes assay and C3d fixing antibodies are not predictive of subclinical ABMR after Kidney Transplantation

PLoS ONE ◽  
2021 ◽  
Vol 16 (4) ◽  
pp. e0249934
Author(s):  
Dominique Bertrand ◽  
Rangolie Kaveri ◽  
Charlotte Laurent ◽  
Philippe Gatault ◽  
Maïté Jauréguy ◽  
...  
Keyword(s):  
Kidney Transplantation ◽  
Prognostic Value ◽  
De Novo ◽  
Added Value ◽  
Multicentric Study ◽  
Specific Antibodies ◽  
Antibody Mediated Rejection ◽  
Single Antigen ◽  
Donor Specific Antibodies ◽  
Allograft Loss

De novo donor-specific antibodies (dnDSA) are associated with antibody-mediated rejection (ABMR) and allograft loss. We tested Immucor* (IM) Luminex Single-antigen beads (LSAB) assay and C3d-fixing antibodies in the setting of dnDSA and subclinical (s) ABMR. This retrospective multicentric study included 123 patients biopsied because of the presence of subclinical de novo DSA detected by One Lamda* Labscreen (MFI > 1000). In 112 patients, sera of the day of the biopsy were available and tested in a central lab with IM Lifecodes LSAB and C3d fixing antibodies assays. In 16 patients (14.3%), no DSA was detected using Immucor test. In 96 patients, at least one DSA was determined with IM. Systematic biopsies showed active sABMR in 30 patients (31.2%), chronic active sABMR in 17 patients (17.7%) and no lesions of sABMR in 49 KT recipients (51%). Intensitity criteria (BCM, BCR and AD-BCR) of DSA were not statistically different between these 3 histological groups. The proportion of patients with C3d-fixing DSA was not statistically different between the 3 groups and did not offer any prognostic value regarding graft survival. Performing biopsy for dnDSA could not be guided by the intensity criteria of IM LSAB assay. C3d-fixing DSA do not offer added value.

Antibody-Mediated Rejection With and Without HLA Donor-Specific Antibodies in Kidney-Transplantation

2018 ◽  
Vol 102 ◽  
pp. S211-S212 ◽  
Author(s):  
Marta Crespo ◽  
Dolores Redondo ◽  
Carrie Butler ◽  
Javier Gimeno ◽  
Carme Garcia ◽  
...  
Keyword(s):  
Kidney Transplantation ◽  
Specific Antibodies ◽  
Antibody Mediated Rejection ◽  
Donor Specific Antibodies

scholarly journals Antibody-Mediated Rejection and Sponge Effect in a Redo Lung Transplant Recipient

2021 ◽  
Vol 2021 ◽  
pp. 1-4
Author(s):  
Ashwini Arjuna ◽  
Michael T. Olson ◽  
Sofya Tokman ◽  
Rajat Walia ◽  
Thalachallour Mohanakumar ◽  
...  
Keyword(s):  
Transplant Recipient ◽  
Lung Transplant ◽  
Human Leukocyte ◽  
Lung Transplant Recipient ◽  
Term Survival ◽  
Antibody Mediated Rejection ◽  
Leukocyte Antigens ◽  
Allograft Failure ◽  
Donor Specific Antibodies

Long-term survival after lung transplant remains severely limited by chronic lung allograft dysfunction. Antibody-mediated rejection of lung transplant allografts is usually caused by donor-specific antibodies (DSAs) directed toward donor human leukocyte antigens (HLAs). Typically, patients with antibody-mediated rejection have significantly higher circulating DSAs and increased mean fluorescence intensity than those without antibody-mediated rejection. However, some patients with antibody-mediated rejection have low mean fluorescence intensities, partly due to the “sponge effect” related to DSAs binding to HLA molecules within the lung. Herein, we report the case of an 18-year-old, female lung transplant recipient who required retransplantation and developed circulating DSAs directed toward the first allograft but detected in circulation only after retransplantation. The present case draws attention to a rare finding of sponge effect in a patient with antibody-mediated rejection leading to allograft failure.

scholarly journals Immunology and Donor-Specific Antibodies in Corneal Transplantation

2021 ◽  
Vol 69 (1) ◽  
Author(s):  
Joanna Major ◽  
Bartosz Foroncewicz ◽  
Jacek Paweł Szaflik ◽  
Krzysztof Mucha
Keyword(s):  
Graft Rejection ◽  
Immunosuppressive Treatment ◽  
Corneal Transplantation ◽  
Corneal Graft ◽  
Corneal Tissue ◽  
Transplant Recipients ◽  
Specific Antibodies ◽  
Antibody Mediated Rejection ◽  
Donor Specific Antibodies ◽  
The Impact

AbstractThe first human corneal transplantation was performed in 1905 by Eduard Zirm in the Olomouc Eye Clinic, now Czech Republic. However, despite great advancements in microsurgical eye procedures, penetrating keratoplasty in high-risk patients (e.g., vascularized or inflamed corneal tissue, consecutive transplants) remains a challenge. The difficulty is mainly due to the risk of irreversible allograft rejection, as an ocular immune privilege in these patients is abolished and graft rejection is the main cause of corneal graft failure. Therefore, tailored immunosuppressive treatment based on immunological monitoring [e.g., donor-specific antibodies (DSA)] is considered one of the best strategies to prevent rejection in transplant recipients. Although there is indirect evidence on the mechanisms underlying antibody-mediated rejection, the impact of DSA on cornea transplantation remains unknown. Determining the role of pre-existing and/or de novo DSA could advance our understanding of corneal graft rejection mechanisms. This may help stratify the immunological risk of rejection, ultimately leading to personalized treatment for this group of transplant recipients.

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