Pretransplant anti-HLA-Cw and anti-HLA-DP antibodies in sensitized patients
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- 作者：Min Ling ; Kwaku Marfo ; Peter Masiakos ; Aws Aljanabi ; Joel Lindower ; Daniel Glicklich ; Graciela de Boccardo ; Stuart Greenstein ; Javier Chapochnick-Friedmann ; Liise Kayler ; Milan Kinkhabwala ; Enver Akalin
- 关键词：cPRA ; calculated panel reactive antibody ; MFI ; mean fluorescence intensity ; HLA ; human leukocyte antigen ; PRA ; panel reactive antibody ; CDC ; complement-dependent-cytotoxicity ; UNOS ; united network for organ sharing ; SPA ; solid phase assay ; DSA ; donor-spec
- 刊名：Human Immunology
- 出版年：2012
- 出版时间：September, 2012
- 年：2012
- 卷：73
- 期：9
- 页码：879-883
- 全文大小：415 K
文摘
We investigated the prevalence and the strength of anti-HLA-Cw and DP antibodies and clinical outcomes in kidney transplant recipients with isolated donor-specific anti-HLA-Cw antibodies. Patients on the waiting list were screened by Luminex single antigen beads (One Lambda). The strength of antibodies was determined by mean fluorescence intensity (MFI) values of the beads. Of the 1069 patients on the waiting list, 251 (24 % ) were sensitized with calculated panel reactive antibody >0 % . The frequency and the median MFI values of anti-HLA antibodies to Cw (56 % , 4955) and DP (35 % , 2945) were lower than anti-HLA-A (79 % , 10,194), B (86 % , 11,235), DR (66 % , 7866) and DQ (69 % , 8283) (p <0.01). Among three major sensitizing events, only previous transplant was associated with development of all anti-HLA antibodies and history of pregnancy was associated only with development of anti-HLA-A antibodies. Eight patients with donor-specific anti-HLA-Cw antibodies received transplantation. During a median 6 months of follow-up (range 3-24 months), patient and graft survival was 100 % without any acute rejection. In summary, the prevalence and the strength of anti-HLA-Cw and HLA-DP were lower compared to anti-HLA-A, B, DR, and DQ antibodies and previous organ transplantation was the main sensitizing event in our cohort of patients.