Nov 11, 2008

Cross Reactive Epitope Group antibodies in sensitized kidneys transplant recipients was associated with early acute Antibody Mediated Rejection

Transplant Immunology
Neha NainaniRocco C Venuto

Abstract

Antibody Mediated Rejection (AMR) is a major cause of early graft loss, graft dysfunction, and chronic allograft nephropathy. Patients with elevated pre-transplant Panel Reactive Antibodies (PRA) are at much higher risk to develop AMR. We, retrospectively, studied the attack rate of AMR in sensitized recipients and evaluated whether preformed antibodies to donor Cross Reactive Epitope Group (CREG) and/or choice of induction immunosuppressive agent affected the frequency of this complication. From the period between September 2002 and March 2008, we identified 19 sensitized renal transplant recipients (with mean PRA of 44.5+/-26%) and recorded the induction agent, number of HLA antigen mismatches, CREG match, CREG antibodies, PRA levels, clinical course, biopsy proven rejection episodes and presence of donor specific antibody. Nine patients were induced with Alemtuzumab (Campath-1H) and ten received horse or rabbit derived polyclonal antithymocyte antibody ATGAM (Pharmacia) or Thymoglobulin (Genzyme). All recipients were cross-match negative at time of transplant. Out of the 19 patients, 9 patients developed acute rejection (47.4%), 4 had AMR and 5 had Acute Cellular Rejection (ACR). Out of 19 patients, 9 patients had existing C...Continue Reading

Mentioned in this Paper

Primary Graft Dysfunction
alemtuzumab
Monoclonal Antibodies
Flow Cytometry
Creatinine
T-Lymphocyte
Histology Procedure
Decreased Immunologic Activity [PE]
Pancreatitis, Graft
Blood Vessel

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