TransplantNow The Ultimate Guide to Clinical Transplant Research

Although testing for HLA antibodies is long-established practice in transplantation, the immune system actually makes antibodies against specific epitopes, not antigens. This study used the HLA Matchmaker program to assess whether the degree of epitope mismatching predicted the development of post-transplant class II donor-specific antibodies. Thresholds for epitope mismatching at DR and DQ were found. […]

There is no consensus on the characteristic features of antibody-mediated rejection (AMR) in lung transplantation. This retrospective cohort study characterized the clinical and pathological features of acute AMR after lung transplantation. Twenty-one patients were identified based on the presence of circulating donor-specific antibodies, histologic evidence of acute lung injury, C4d deposition, and clinical allograft dysfunction.

The ability to detect anti-HLA antibodies is very sensitive and specific, but it is not clear if all antibodies are the same. Specifically, some antibodies may bind and activate complement better than others. In this retrospective study, the presence of antibodies that could fix C1q and initiate the complement cascade was associated with higher rates […]

Antibody-mediated rejection is a well recognized cause of accelerated allograft dysfunction in heart and kidney transplantation in the setting of de novo donor specific antibodies (DSA). Development of de novo DSA in lung transplant recipients has been linked with early development of bronchiolitis obliterans syndrome (BOS), although the role of antibody-mediated rejection in BOS is […]

The best strategy to manage patients with a failed renal allograft is unknown. It is unknown whether the allograft acts a “sponge” for DSA, and removal may lead to higher levels of anti-HLA antibodies. This study compared patients whose immunosuppression stopped, and who either underwent a graft nephrectomy or not. Allograft nephrectomy resulted in a […]

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 […]

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 […]

Antibody mediated rejection (AMR) is a well described phenomenon in kidney and heart transplant but its presence and impact on intestinal transplantation is unclear. AMR might contribute to the severity and relatively high rate of steroid resistant acute rejection in intestinal transplantation. This prospective study measured and correlated donor specific antibodies (DSA) levels to episodes […]

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. […]

There is ongoing debate as to the clinical importance of late rejection following heart transplantation detected on routine biopsy.  More and more programs have moved away from routine biopsies beyond 3-5 years post-transplant, negating the possibility of even detecting this late rejection.  In this provocative study, the authors assess both the pathologic charactistics, presence of […]