Development of posttransplant antidonor HLA antibodies is associated with acute humoral rejection and early graft dysfunction
The goal of this study was to determine whether the production of posttransplant antibodies directed against donor HLA mismatches (donor specific antibody; DSA) is associated with renal allograft rejection and early graft dysfunction. Forty-nine adult renal allograft recipients with increased risk o...
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| Veröffentlicht in: | Transplantation 2005-03, Vol.79 (5), p.591-598 |
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| creator | QIUHENG ZHANG LIANG, Leonard W GJERTSON, David W LASSMAN, Charles WILKINSON, Alan H KENDRICK, Elizabeth PHAM, Phuong-Thu T DANOVITCH, Gabriel M ALBIN GRITSCH, H REED, Elaine F |
| description | The goal of this study was to determine whether the production of posttransplant antibodies directed against donor HLA mismatches (donor specific antibody; DSA) is associated with renal allograft rejection and early graft dysfunction.
Forty-nine adult renal allograft recipients with increased risk of rejection were enrolled during the period of October 2001 through May 2003 and were prospectively monitored for the development of anti-HLA antibodies.
Of 49 patients, eight (16.3 %) patients were diagnosed with acute humoral rejection (AHR) and 11/49 (22.4%) patients were diagnosed with acute cellular rejection (ACR). A strong association between pretransplant HLA sensitization and AHR was found (P=0.005). Of the eight patients diagnosed with AHR, the majority developed DSA before or concomitant with episodes of rejection (P |
| doi_str_mv | 10.1097/01.TP.0000155246.52249.AC |
| format | Article |
| fullrecord | <record><control><sourceid>proquest_cross</sourceid><recordid>TN_cdi_proquest_miscellaneous_67499255</recordid><sourceformat>XML</sourceformat><sourcesystem>PC</sourcesystem><sourcerecordid>17844149</sourcerecordid><originalsourceid>FETCH-LOGICAL-c427t-ca3d529ae67c87f81bf1d3a179272fe9b785dbac4e57fb2a89de2838b73110c43</originalsourceid><addsrcrecordid>eNqFkUtv1DAURi0EokPhLyCzgF2Cn7G9HA2UIo1EF8PacvygqZI42E7RLPjvuNORZomlK8vX57uWdQD4gFGLkRKfEW4Pdy2qC3NOWNdyQphqt7sXYIM5ZU2HJHoJNggx3GBKxRV4k_ND5TkV4jW4wlxwKpnagL9f_KMf4zL5ucAY4BJzKcnMeRlN7dQaXJxjgrf77enURzf4DIcMTc7RDqZ4B_8M5R4auxYP79cpJjPC5B-8LUOca8pBb9J4hL-SCQW6Yw7rfLp7C14FM2b_7rxfg583Xw-722b_49v33XbfWEZEaayhjhNlfCesFEHiPmBHDRaKCBK86oXkrjeWeS5CT4xUzhNJZS8oxsgyeg0-Pc9dUvy9-lz0NGTrx_pHH9esO8GUIpz_F8RCMoaZqqB6Bm2KOScf9JKGyaSjxkg_SdII68OdvkjSJ0l6u6vZ9-dH1n7y7pI8W6nAxzNgsjVjqD7skC9c13VKKEr_AZcRnd4</addsrcrecordid><sourcetype>Aggregation Database</sourcetype><iscdi>true</iscdi><recordtype>article</recordtype><pqid>17844149</pqid></control><display><type>article</type><title>Development of posttransplant antidonor HLA antibodies is associated with acute humoral rejection and early graft dysfunction</title><source>MEDLINE</source><source>Journals@Ovid Complete</source><creator>QIUHENG ZHANG ; LIANG, Leonard W ; GJERTSON, David W ; LASSMAN, Charles ; WILKINSON, Alan H ; KENDRICK, Elizabeth ; PHAM, Phuong-Thu T ; DANOVITCH, Gabriel M ; ALBIN GRITSCH, H ; REED, Elaine F</creator><creatorcontrib>QIUHENG ZHANG ; LIANG, Leonard W ; GJERTSON, David W ; LASSMAN, Charles ; WILKINSON, Alan H ; KENDRICK, Elizabeth ; PHAM, Phuong-Thu T ; DANOVITCH, Gabriel M ; ALBIN GRITSCH, H ; REED, Elaine F</creatorcontrib><description>The goal of this study was to determine whether the production of posttransplant antibodies directed against donor HLA mismatches (donor specific antibody; DSA) is associated with renal allograft rejection and early graft dysfunction.
Forty-nine adult renal allograft recipients with increased risk of rejection were enrolled during the period of October 2001 through May 2003 and were prospectively monitored for the development of anti-HLA antibodies.
Of 49 patients, eight (16.3 %) patients were diagnosed with acute humoral rejection (AHR) and 11/49 (22.4%) patients were diagnosed with acute cellular rejection (ACR). A strong association between pretransplant HLA sensitization and AHR was found (P=0.005). Of the eight patients diagnosed with AHR, the majority developed DSA before or concomitant with episodes of rejection (P<0.001). Only 3 of 41 patients (7.3%) without AHR developed DSA. The pathogenic role of alloantibodies was further substantiated by analyzing their association with graft function as measured by serum creatinine levels. The average serum creatinine after the third month posttransplantation in DSA producers was 2.24+/-1.01 mg/dL, while in non-DSA patients the average serum creatinine was 1.41+/-0.37 mg/dL (P<0.01).
This study reveals a strong association between the production of DSA, AHR, and early graft dysfunction. Our findings indicate that prospective monitoring for anti-HLA antibodies following transplantation is a useful test for the diagnosis and classification of AHR for identifying patients at risk of early graft dysfunction.</description><identifier>ISSN: 0041-1337</identifier><identifier>EISSN: 1534-6080</identifier><identifier>DOI: 10.1097/01.TP.0000155246.52249.AC</identifier><identifier>PMID: 15753849</identifier><identifier>CODEN: TRPLAU</identifier><language>eng</language><publisher>Hagerstown, MD: Lippincott</publisher><subject>Acute Disease ; Adult ; Aged ; Biological and medical sciences ; Female ; Fundamental and applied biological sciences. Psychology ; Fundamental immunology ; Graft Rejection - etiology ; HLA Antigens - immunology ; Humans ; Isoantibodies - biosynthesis ; Kidney Transplantation - immunology ; Male ; Medical sciences ; Middle Aged ; Surgery (general aspects). Transplantations, organ and tissue grafts. Graft diseases ; Tissue Donors ; Tissue, organ and graft immunology</subject><ispartof>Transplantation, 2005-03, Vol.79 (5), p.591-598</ispartof><rights>2005 INIST-CNRS</rights><lds50>peer_reviewed</lds50><oa>free_for_read</oa><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c427t-ca3d529ae67c87f81bf1d3a179272fe9b785dbac4e57fb2a89de2838b73110c43</citedby><cites>FETCH-LOGICAL-c427t-ca3d529ae67c87f81bf1d3a179272fe9b785dbac4e57fb2a89de2838b73110c43</cites></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><link.rule.ids>315,782,786,27931,27932</link.rule.ids><backlink>$$Uhttp://pascal-francis.inist.fr/vibad/index.php?action=getRecordDetail&idt=16669793$$DView record in Pascal Francis$$Hfree_for_read</backlink><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/15753849$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>QIUHENG ZHANG</creatorcontrib><creatorcontrib>LIANG, Leonard W</creatorcontrib><creatorcontrib>GJERTSON, David W</creatorcontrib><creatorcontrib>LASSMAN, Charles</creatorcontrib><creatorcontrib>WILKINSON, Alan H</creatorcontrib><creatorcontrib>KENDRICK, Elizabeth</creatorcontrib><creatorcontrib>PHAM, Phuong-Thu T</creatorcontrib><creatorcontrib>DANOVITCH, Gabriel M</creatorcontrib><creatorcontrib>ALBIN GRITSCH, H</creatorcontrib><creatorcontrib>REED, Elaine F</creatorcontrib><title>Development of posttransplant antidonor HLA antibodies is associated with acute humoral rejection and early graft dysfunction</title><title>Transplantation</title><addtitle>Transplantation</addtitle><description>The goal of this study was to determine whether the production of posttransplant antibodies directed against donor HLA mismatches (donor specific antibody; DSA) is associated with renal allograft rejection and early graft dysfunction.
Forty-nine adult renal allograft recipients with increased risk of rejection were enrolled during the period of October 2001 through May 2003 and were prospectively monitored for the development of anti-HLA antibodies.
Of 49 patients, eight (16.3 %) patients were diagnosed with acute humoral rejection (AHR) and 11/49 (22.4%) patients were diagnosed with acute cellular rejection (ACR). A strong association between pretransplant HLA sensitization and AHR was found (P=0.005). Of the eight patients diagnosed with AHR, the majority developed DSA before or concomitant with episodes of rejection (P<0.001). Only 3 of 41 patients (7.3%) without AHR developed DSA. The pathogenic role of alloantibodies was further substantiated by analyzing their association with graft function as measured by serum creatinine levels. The average serum creatinine after the third month posttransplantation in DSA producers was 2.24+/-1.01 mg/dL, while in non-DSA patients the average serum creatinine was 1.41+/-0.37 mg/dL (P<0.01).
This study reveals a strong association between the production of DSA, AHR, and early graft dysfunction. Our findings indicate that prospective monitoring for anti-HLA antibodies following transplantation is a useful test for the diagnosis and classification of AHR for identifying patients at risk of early graft dysfunction.</description><subject>Acute Disease</subject><subject>Adult</subject><subject>Aged</subject><subject>Biological and medical sciences</subject><subject>Female</subject><subject>Fundamental and applied biological sciences. Psychology</subject><subject>Fundamental immunology</subject><subject>Graft Rejection - etiology</subject><subject>HLA Antigens - immunology</subject><subject>Humans</subject><subject>Isoantibodies - biosynthesis</subject><subject>Kidney Transplantation - immunology</subject><subject>Male</subject><subject>Medical sciences</subject><subject>Middle Aged</subject><subject>Surgery (general aspects). Transplantations, organ and tissue grafts. Graft diseases</subject><subject>Tissue Donors</subject><subject>Tissue, organ and graft immunology</subject><issn>0041-1337</issn><issn>1534-6080</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2005</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><recordid>eNqFkUtv1DAURi0EokPhLyCzgF2Cn7G9HA2UIo1EF8PacvygqZI42E7RLPjvuNORZomlK8vX57uWdQD4gFGLkRKfEW4Pdy2qC3NOWNdyQphqt7sXYIM5ZU2HJHoJNggx3GBKxRV4k_ND5TkV4jW4wlxwKpnagL9f_KMf4zL5ucAY4BJzKcnMeRlN7dQaXJxjgrf77enURzf4DIcMTc7RDqZ4B_8M5R4auxYP79cpJjPC5B-8LUOca8pBb9J4hL-SCQW6Yw7rfLp7C14FM2b_7rxfg583Xw-722b_49v33XbfWEZEaayhjhNlfCesFEHiPmBHDRaKCBK86oXkrjeWeS5CT4xUzhNJZS8oxsgyeg0-Pc9dUvy9-lz0NGTrx_pHH9esO8GUIpz_F8RCMoaZqqB6Bm2KOScf9JKGyaSjxkg_SdII68OdvkjSJ0l6u6vZ9-dH1n7y7pI8W6nAxzNgsjVjqD7skC9c13VKKEr_AZcRnd4</recordid><startdate>20050315</startdate><enddate>20050315</enddate><creator>QIUHENG ZHANG</creator><creator>LIANG, Leonard W</creator><creator>GJERTSON, David W</creator><creator>LASSMAN, Charles</creator><creator>WILKINSON, Alan H</creator><creator>KENDRICK, Elizabeth</creator><creator>PHAM, Phuong-Thu T</creator><creator>DANOVITCH, Gabriel M</creator><creator>ALBIN GRITSCH, H</creator><creator>REED, Elaine F</creator><general>Lippincott</general><scope>IQODW</scope><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>7T5</scope><scope>H94</scope><scope>7X8</scope></search><sort><creationdate>20050315</creationdate><title>Development of posttransplant antidonor HLA antibodies is associated with acute humoral rejection and early graft dysfunction</title><author>QIUHENG ZHANG ; LIANG, Leonard W ; GJERTSON, David W ; LASSMAN, Charles ; WILKINSON, Alan H ; KENDRICK, Elizabeth ; PHAM, Phuong-Thu T ; DANOVITCH, Gabriel M ; ALBIN GRITSCH, H ; REED, Elaine F</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c427t-ca3d529ae67c87f81bf1d3a179272fe9b785dbac4e57fb2a89de2838b73110c43</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2005</creationdate><topic>Acute Disease</topic><topic>Adult</topic><topic>Aged</topic><topic>Biological and medical sciences</topic><topic>Female</topic><topic>Fundamental and applied biological sciences. Psychology</topic><topic>Fundamental immunology</topic><topic>Graft Rejection - etiology</topic><topic>HLA Antigens - immunology</topic><topic>Humans</topic><topic>Isoantibodies - biosynthesis</topic><topic>Kidney Transplantation - immunology</topic><topic>Male</topic><topic>Medical sciences</topic><topic>Middle Aged</topic><topic>Surgery (general aspects). Transplantations, organ and tissue grafts. Graft diseases</topic><topic>Tissue Donors</topic><topic>Tissue, organ and graft immunology</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>QIUHENG ZHANG</creatorcontrib><creatorcontrib>LIANG, Leonard W</creatorcontrib><creatorcontrib>GJERTSON, David W</creatorcontrib><creatorcontrib>LASSMAN, Charles</creatorcontrib><creatorcontrib>WILKINSON, Alan H</creatorcontrib><creatorcontrib>KENDRICK, Elizabeth</creatorcontrib><creatorcontrib>PHAM, Phuong-Thu T</creatorcontrib><creatorcontrib>DANOVITCH, Gabriel M</creatorcontrib><creatorcontrib>ALBIN GRITSCH, H</creatorcontrib><creatorcontrib>REED, Elaine F</creatorcontrib><collection>Pascal-Francis</collection><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>Immunology Abstracts</collection><collection>AIDS and Cancer Research Abstracts</collection><collection>MEDLINE - Academic</collection><jtitle>Transplantation</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>QIUHENG ZHANG</au><au>LIANG, Leonard W</au><au>GJERTSON, David W</au><au>LASSMAN, Charles</au><au>WILKINSON, Alan H</au><au>KENDRICK, Elizabeth</au><au>PHAM, Phuong-Thu T</au><au>DANOVITCH, Gabriel M</au><au>ALBIN GRITSCH, H</au><au>REED, Elaine F</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Development of posttransplant antidonor HLA antibodies is associated with acute humoral rejection and early graft dysfunction</atitle><jtitle>Transplantation</jtitle><addtitle>Transplantation</addtitle><date>2005-03-15</date><risdate>2005</risdate><volume>79</volume><issue>5</issue><spage>591</spage><epage>598</epage><pages>591-598</pages><issn>0041-1337</issn><eissn>1534-6080</eissn><coden>TRPLAU</coden><abstract>The goal of this study was to determine whether the production of posttransplant antibodies directed against donor HLA mismatches (donor specific antibody; DSA) is associated with renal allograft rejection and early graft dysfunction.
Forty-nine adult renal allograft recipients with increased risk of rejection were enrolled during the period of October 2001 through May 2003 and were prospectively monitored for the development of anti-HLA antibodies.
Of 49 patients, eight (16.3 %) patients were diagnosed with acute humoral rejection (AHR) and 11/49 (22.4%) patients were diagnosed with acute cellular rejection (ACR). A strong association between pretransplant HLA sensitization and AHR was found (P=0.005). Of the eight patients diagnosed with AHR, the majority developed DSA before or concomitant with episodes of rejection (P<0.001). Only 3 of 41 patients (7.3%) without AHR developed DSA. The pathogenic role of alloantibodies was further substantiated by analyzing their association with graft function as measured by serum creatinine levels. The average serum creatinine after the third month posttransplantation in DSA producers was 2.24+/-1.01 mg/dL, while in non-DSA patients the average serum creatinine was 1.41+/-0.37 mg/dL (P<0.01).
This study reveals a strong association between the production of DSA, AHR, and early graft dysfunction. Our findings indicate that prospective monitoring for anti-HLA antibodies following transplantation is a useful test for the diagnosis and classification of AHR for identifying patients at risk of early graft dysfunction.</abstract><cop>Hagerstown, MD</cop><pub>Lippincott</pub><pmid>15753849</pmid><doi>10.1097/01.TP.0000155246.52249.AC</doi><tpages>8</tpages><oa>free_for_read</oa></addata></record> |
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| ispartof | Transplantation, 2005-03, Vol.79 (5), p.591-598 |
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| source | MEDLINE; Journals@Ovid Complete |
| subjects | Acute Disease Adult Aged Biological and medical sciences Female Fundamental and applied biological sciences. Psychology Fundamental immunology Graft Rejection - etiology HLA Antigens - immunology Humans Isoantibodies - biosynthesis Kidney Transplantation - immunology Male Medical sciences Middle Aged Surgery (general aspects). Transplantations, organ and tissue grafts. Graft diseases Tissue Donors Tissue, organ and graft immunology |
| title | Development of posttransplant antidonor HLA antibodies is associated with acute humoral rejection and early graft dysfunction |
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