Non-HLA transplantation immunity revealed by lymphocytotoxic antibodies

Lancet
Gerhard Opelz, Collaborative Transplant Study

Abstract

The presence of panel-reactive antibodies (PRA) against HLA antigens before transplantation is associated with early rejection of kidney grafts from cadaver donors. Transplants from HLA-identical sibling donors do not provide a target for antibodies to HLA antigens and should therefore not be affected by PRA. Data from the Collaborative Transplant Study were used to examine the influence of PRA on graft survival. Uncensored graft survival and death-censored graft survival were calculated, and the data were analysed by multivariate Cox's regression methods. Among recipients of HLA-identical sibling transplants, 3001 patients with no PRA had significantly higher 10-year graft survival (72.4% [SE 1.1]) than 803 patients with 1-50% PRA (63.3% [2.5]; p=0.0006) or 244 patients with more than 50% PRA (55.5% [4.0]; p<0.0001). The effect of PRA became apparent after the first post-transplant year and was, therefore, strikingly different from the early steep decline in graft survival during the first year associated with PRA in recipients of cadaver kidneys. We could not discern whether graft loss was a direct effect of non-HLA humoral sensitisation or whether PRA served as an indicator of heightened immunity against non-HLA transplantat...Continue Reading

References

Mar 19, 2011·Langenbeck's Archives of Surgery·Christian MorathCaner Süsal
Jan 25, 2011·Pediatric Nephrology : Journal of the International Pediatric Nephrology Association·Peter StastnyBhavna Lavingia
Jan 27, 2010·Immunologic Research·Andrea A ZacharyMary S Leffell
Aug 26, 2006·Nature Clinical Practice. Nephrology·Pierre RoncoVincent Guigonis
Sep 28, 2007·The New England Journal of Medicine·Yizhou ZouGerhard Opelz
Mar 3, 2009·Proceedings of the National Academy of Sciences of the United States of America·Li LiAtul J Butte
May 29, 2009·Nephrology, Dialysis, Transplantation : Official Publication of the European Dialysis and Transplant Association - European Renal Association·Jeroen AaltenA J Hoitsma
Oct 23, 2009·Nephrology, Dialysis, Transplantation : Official Publication of the European Dialysis and Transplant Association - European Renal Association·Carrie A GrafftHatem Amer
Feb 8, 2013·Nephrology, Dialysis, Transplantation : Official Publication of the European Dialysis and Transplant Association - European Renal Association·Karminder S GillBrian D Bradbury
Oct 6, 2005·Current Opinion in Nephrology and Hypertension·Helmut E Feucht, Michael J Mihatsch
Mar 15, 2006·Transplantation·Brian J Nankivell, Jeremy R Chapman
Jul 11, 2006·Transplantation·Denis GlotzCaroline Suberbielle-Boissel
Aug 14, 2008·Transplantation·Paul I Terasaki, Junchao Cai
Mar 21, 2009·Transplantation·John D SmithMarlene L Rose
Mar 12, 2010·Transplantation·Andreas HeinoldThuong Hien Tran
Jul 31, 2010·Transplantation·Christian MorathCaner Süsal
Apr 29, 2011·Transplantation·Manuel AriasManuel Praga
Jul 29, 2011·Nephrology·Paul J PhelanPeter J Conlon
Feb 2, 2013·Circulation Research·Patricia E de AlmeidaJoseph C Wu
Feb 26, 2013·Clinical and Translational Medicine·Batool Mutar Mahdi
Oct 4, 2012·Experimental and Clinical Transplantation : Official Journal of the Middle East Society for Organ Transplantation·Antoine BarbariMahassen Jaafar
Jan 15, 2014·Nephrology, Dialysis, Transplantation : Official Publication of the European Dialysis and Transplant Association - European Renal Association·Priya S VergheseMichael S Mauer
Feb 12, 2014·Journal of Nephrology·Paul J PhelanMatthew A Sparks
Jul 1, 2014·Transplantation·Dler BesaraniSusan V Fuggle
Sep 27, 2014·Transplant Immunology·H G OttenF H J Claas
Dec 3, 2014·Néphrologie & thérapeutique·Christophe LegendreDany Anglicheau

Citations

Feb 1, 1971·Postgraduate Medical Journal·Paul I TerasakiR M Mickey
Mar 8, 2002·European Journal of Immunogenetics : Official Journal of the British Society for Histocompatibility and Immunogenetics·E SimpsonP J Dyson
May 1, 2002·Transplantation·Caner Süsal, Gerhard Opelz
Dec 21, 2002·Tissue Antigens·S G E MarshPaul I Terasaki
Dec 5, 1964·Nature·Paul I Terasaki, J D MCCLELLAND

Related Concepts

Autoantibodies
Decreased Immunologic Activity [PE]
Histocompatibility Antigens
Lymphocytes as Percentage of Blood Leukocytes (Lab Test)
Pancreatitis, Graft
Minor Histocompatibility Antigens
Graft Survival
Isoantibodies
HLA Antigens
Kidney

Related Feeds

Anxiety Disorders

Discover the latest research on anxiety disorders including agoraphobia, panic disorder, obsessive-compulsive disorder, and post-traumatic stress disorder here.

Related Papers

The New England Journal of Medicine
Yizhou ZouGerhard Opelz
American Journal of Transplantation : Official Journal of the American Society of Transplantation and the American Society of Transplant Surgeons
Paul I Terasaki
American Journal of Transplantation : Official Journal of the American Society of Transplantation and the American Society of Transplant Surgeons
Paul I TerasakiR Castro
American Journal of Transplantation : Official Journal of the American Society of Transplantation and the American Society of Transplant Surgeons
Kazuo MizutaniJarhow Lee
© 2020 Meta ULC. All rights reserved