Surveillance of alloantibodies after transplantation identifies the risk of chronic rejection.

Abstract:

:The monitoring of the levels of alloantibodies following transplantation might facilitate early diagnosis of chronic rejection (CR), the leading cause of renal allograft failure. Here, we used serial alloantibody surveillance to monitor patients with preoperative positive flow cytometric crossmatch (FCXM). Sixty-nine of 308 renal transplant patients in our center had preoperative positive FCXM. Blood was collected quarterly during the first postoperative year and tested by FCXM and single antigen bead luminometry, more sensitive techniques than complement-dependent cytotoxic crossmatching. Distinct post-transplant profiles emerged and were associated with different clinical outcomes. Two-thirds of patients showed complete elimination of FCXM and solid-phase assay reactions within 1 year, had few adverse events, and a 95% 3-year graft survival. In contrast, the remaining third failed to eliminate flow FCXM or solid-phase reactions directed against HLA class I or II antibodies. The inferior graft survival (67%) with loss in this latter group was primarily due to CR. Thus, systematic assessment of longitudinal changes in alloantibody levels, either by FCXM or solid-phase assay, can help identify patients at greater risk of developing CR.

journal_name

Kidney Int

journal_title

Kidney international

authors

Kimball PM,Baker MA,Wagner MB,King A

doi

10.1038/ki.2010.556

subject

Has Abstract

pub_date

2011-05-01 00:00:00

pages

1131-7

issue

10

eissn

0085-2538

issn

1523-1755

pii

S0085-2538(15)54703-0

journal_volume

79

pub_type

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