Autolymphocytotoxic antibodies in patients on dialysis awaiting renal transplantation

Transplantation
R B EttengerR N Fine

Abstract

Two-hundred eighty sera from 78 dialysis patients were examined for autolymphocytotoxic antibodies (ALCAs). Thirty-five (12%) sera in 18 (23%) patients had ALCAs. Eight patients had ALCAs in multiple sera. Two patients had ALCAs against both T and B lymphocytes, 2 against T lymphocytes, and 14 against B lymphocytes. In those sera with ALCAs against both B and T lymphocytes, broad thermal reactivity was present. In sera with ALCAs against only B lymphocytes, the majority were reactive at 5 C. Sixteen (89%) patients with ALCAs had some form of glomerulonephritis; five had rapidly progressive glomerulonephritis (RPGN) and three had systemic lupus erythematosis (SLE). Nine of 10 sera with a positive crossmatch against B lymphocytes from a renal transplant donor did not have ALCAs against autologous B lymphocytes; three sera with ALCAs against B lymphocytes and two with ALCAs against T lymphocytes had negative crossmatches against transplant donor lymphocytes. Positive crossmatches against donor B and T lymphocytes attributable solely to ALCAs were therefore uncommon in our patients. Nevertheless, patients at risk to develop ALCA, including those with SLE and RPGN, should be identified and their sera tested for ALCAs. Once identifie...Continue Reading

Citations

Feb 28, 2003·Transplantation·Stéphanie Le Bas-BernardetJean-Denis Bignon
Jan 1, 1996·Transplant International : Official Journal of the European Society for Organ Transplantation·D J BevanM Bewick
Jan 1, 1985·The Journal of Surgical Research·C M Zmijewski
Jan 1, 1982·Immunological Reviews·P J Morris, A Ting
Oct 12, 1985·British Medical Journal·P K DonnellyR Wilkinson

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