Posts Tagged ‘immunology’

May 23, 2012

Frequency of HLA-DP-specific antibodies and a possible new cross-reacting group


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Donor specific HLA antibodies to mismatched class II antigens are a common feature of late kidney graft loss. Although antibodies to HLA-DR and _DQ antigens have been recognized for quite some time, antibodies to HLA-DP have an unclear clinical significance. This study examined the incidence of HLA-DP-specific antibodies in 650 patients on the kidney transplant […]

No Comments Posted in Renal Transplantation
May 23, 2012

Pretransplant Donor-Specific HLA Class-I and -II Antibodies Are Associated with an Increased Risk for Kidney Graft Failure


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The recent development of Luminex reagents capable of detecting complement fixing HLA antibodies has sparked a lot of interest in the best way to apply this information. This study examined C1Q-fixing HLA antibodies in a retrospective study of pre-transplant samples in patients transplanted across a negative cytotoxic cross-match. Of the 837 sera examined, 210 contained […]

No Comments Posted in Renal Transplantation
May 23, 2012

Durability of Antibody Removal Following Proteasome Inhibitor-Based Therapy


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Experience with proteasome inhibitors (PI) for treating antibody-mediated rejection (ABMR) and HLA antibody removal is increasing. However, the durability of the effects PI on HLA antibody removal is unknown. This study examines this question from a unique point of view due to the use of the PI bortezomib as either a combination therapy or a […]

No Comments Posted in Renal Transplantation
May 23, 2012

A Novel Pathway of Chronic Allograft Rejection Mediated by NK Cells and Alloantibody


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A major obstacle to the long-term survival of human heart allografts is chronic allograft vasculopathy (CAV), a pathologic state thought to be mediated by donor specific HLA antibody (DSA). This article defines the mechanism for DSA-mediated CAV in a mouse model. The analysis points to a clear role for NK cells in the generation of […]

No Comments Posted in Cardiac Transplantation
February 23, 2012

Prevention and treatment of alloantibody-mediated kidney rejection


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The problem of antibody-mediated rejection (ABMR) due to donor specific HLA antibodies continues to challenge transplant programs as we struggle to find effective treatments. This very detailed review carefully outlines the various treatment options attempted in dealing with ABMR or desensitization including some not so common protocols such as immunoadsorption. Furthermore, insightful views regarding organ […]

No Comments Posted in Renal Transplantation
February 23, 2012

Allosensitization and outcomes in pediatric heart transplantation


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Allosensitization of pediatric heart transplant candidates continues to be a problem with uncertainty on the best clinical approach to manage these patients. Using data from the Pediatric Heart Transplant Study, the current study examined >3000 patients listed for heart transplantation of which 2237 were transplanted with available panel reactive antibody (PRA) data. The outcomes for […]

No Comments Posted in Cardiac Transplantation
February 23, 2012

Terminal complement inhibition decreases antibody-mediated rejection in sensitized renal transplant recipients


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Antibody-mediated rejection (ABMR)in the presence of high levels of donor-specific antibodies (DSA) likely involves complement activation as part of the mechanism of graft damage. This study examined the efficacy of inhibiting complement activation by neutralizing C5 with a humanized anti-C5 antibody; eculizumab. The effect of anti-C5 treatment was assessed in 26 highly sensitized recipients of […]

No Comments Posted in Renal Transplantation
February 23, 2012

Reduction of alloantibodies via proteosome inhibition in cardiac transplantation


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HLA antibodies produced by plasma cells are a major barrier for patients awaiting heart transplantation due to increased wait list time, increased risk of rejection post-transplant, and decreased survival. Proteasome inhibition using bortezomib can lead to plasma cell apoptosis and potentially decrease antibody production. As already shown in renal transplants where bortezomib decreases antibody production […]

No Comments Posted in Cardiac Transplantation
February 23, 2012

Posttransplant Donor-Specific Anti-HLA Antibodies Negatively Impact Pancreas Transplantation Outcome


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Continuing on with other recent developments related to antibody-mediated rejection of pancreas transplants, the current study reinforces the strong effect of donor-specific antibodies (DSA) on graft survival in simultaneous pancreas-kidney transplant patients. A total of 167 pancreas transplants (152 pancreas-kidney) were followed for the  development of HLA antibodies and DSA during 9 years of follow-up. […]

No Comments Posted in Pancreas Transplantation