Defining unacceptable HLA antigens

Zachary, Andrea A.; Montgomery, Robert A.; Leffell, Mary S.

doi:10.1097/mot.0b013e3283071450

Cited by 41 publications

(32 citation statements)

References 45 publications

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“…Some unacceptable HLA antigens are sufficiently rare that the CPRA value rounds to zero; however, kidneys from donors with those rare antigens are not offered to the patient. The CPRA is based on HLA-A,-B,-DR and -DQ frequencies derived from the phenotypes of 12 061 donors in the OPTN registry as previously described (8). The HLA-C antigens are currently excluded from the CPRA calculation because there was inadequate donor typing data to estimate their frequencies.…”

Section: Methodsmentioning

confidence: 99%

Calculated PRA: Initial Results Show Benefits for Sensitized Patients and a Reduction in Positive Crossmatches

Cecka

Kucheryavaya²,

Reinsmoen

et al. 2011

American Journal of Transplantation

154

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Section: Methodsmentioning

confidence: 99%

Calculated PRA: Initial Results Show Benefits for Sensitized Patients and a Reduction in Positive Crossmatches

Cecka

Kucheryavaya²,

Reinsmoen

et al. 2011

American Journal of Transplantation

154

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“…This correlation allowed prediction of the result of flow cytometry and CDC crossmatches in 92.8 and 92.4 % of cases. One of the major issues in virtual crossmatch using solid-phase assays is nonstandardized interpretation; therefore, antibody strength and titer, complement fixation, and sensitization events must be accurately considered [41,43,44]. Gandhi et al [45], in a retrospective study on heart transplantation, defined a virtual crossmatch as negative when MFI values, referring to antibodies identified by SA, were \300, and as positive for MFI values [1500.…”

Section: Virtual and Luminex Crossmatchmentioning

confidence: 99%

“…The ability of Luminex to identify anti-HLA antibodies has improved the definition of acceptable and unacceptable antigens, facilitating exchange of organs between different centers to facilitate transplantation in highly immunized patients [41]. Nevertheless, several studies have shown that low antibody levels are not always associated with adverse effects.…”

Section: Virtual and Luminex Crossmatchmentioning

confidence: 99%

Luminex and antibody detection in kidney transplantation

2012

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Preformed anti-human leukocyte antigen (HLA) antibodies have a negative effect on kidney transplantation outcome with an increased rejection rate and reduction in survival. Posttransplantation production of donor-specific anti-HLA antibodies is indicative of an active immune response and risk of transplantation rejection. For many years the primary technique for anti-HLA antibody detection was complement-dependent cytotoxicity (CDC), which has been integrated by solid-phase assays as HLA antigen-coated bead methods (Luminex). This new technological approach has allowed identification of anti-HLA antibodies, not detectable using conventional CDC method, in patients awaiting kidney transplantation. Moreover, use of Luminex technology has enabled better definition of acceptable or unacceptable antigens favoring transplantation in highly immunized patients. However, there are still many unresolved issues, including the clinical relevance of antibodies detected with this system.

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“…Также необходимо выпол-нение и донору, и реципиенту HLA-типирования с высоким разрешением. Задачами иммунологиче-ского подбора донорского органа следует считать, во-первых, отсутствие у донора тех антигенов HLA, к которым у кандидата на трансплантацию есть ан-титела, и во-вторых, достижение максимальной совместимости по системе HLA [6]. Недостатком такого метода, особенно в группе высокосенсиби-лизированных пациентов, является значимое увели-чение сроков ожидания трансплантации.…”

Section: заключениеunclassified

Challenges in Treatment of Renal Graft Acute Antibody-Mediated Rejection

Сушков

Шаршаткин

2016

RJTAO

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ВВЕДЕНИЕНа протяжении последних десяти лет одной из наиболее актуальных проблем клинической транс-плантации почки является профилактика и лечение острого антителоопосредованного (гуморального) отторжения [1,2]. Это обусловлено целым рядом факторов и обстоятельств. Во-первых, наблюдается устойчивый рост количества кандидатов в «листах ожидания», которые имеют предсуществующие ан-ти-HLA антитела, при этом большинство этих паци-ентов нуждается в повторной трансплантации [3]. Во-вторых, это внедрение в рутинную лаборатор-ную практику сверхчувствительных твердофазных методов определения специфичности и количества анти-HLA антител, которые радикальным образом DOI: 10.15825/1995DOI: 10.15825/ -1191DOI: 10.15825/ -2016 ТРУДНЫЕ РЕШЕНИЯ ПРИ ЛЕЧЕНИИ ОСТРОГО ГУМОРАЛЬНОГО ОТТОРЖЕНИЯ ПЕРЕСАЖЕННОЙ ПОЧКИ А.И. Сушков, А.В. ШаршаткинФГБУ «Федеральный научный центр трансплантологии и искусственных органов» Минздрава России, Москва, Российская Федерация Несмотря на многочисленные исследования, консенсус в отношении критериев диагностики и методов лечения острого гуморального отторжения почечного трансплантата до сих пор не достигнут. В данном наблюдении мы приводим случай развития раннего тяжелого гуморального отторжения. Прогрессивное ухудшение состояния больного на фоне терапии и ее неэффективность привели к решению об удалении трансплантата. Однако на операции трансплантат имел жизнеспособный вид и не был удален. Повтор-ный курс терапии отторжения (плазмаферез, антитимоцитарный глобулин, внутривенный иммуногло-булин и ритуксимаб) оказался эффективным. К настоящему моменту срок наблюдения составляет 1 год, функция трансплантата остается удовлетворительной и стабильной.Ключевые слова: трансплантация почки, отторжение трансплантата. CHALLENGES IN TREATMENT OF RENAL GRAFT ACUTE ANTIBODY-MEDIATED REJECTION A.I. Sushkov, A.V. Sharshatkin V.I. Shumakov Federal Research Center of Transplantology and Artifi cial Organs of the Ministry of Healthcare of the Russian Federation, Moscow, Russian FederationDiagnostic criteria and treatment protocols for acute antibody-mediated rejection (AMR) of kidney allograft remain controversial. We report the case of early severe AMR after primary kidney transplantation. The graft removal was considered in the absence of treatment effi cacy and in the presence of systemic infl ammatory response syndrome. However, at surgery the graft looked normal and it was not removed. The repeated treatment course (plasmapheresis, antithymocyte globulin, intravenous immunoglobulin and rituximab) was effective. The patient has good and stable graft function in 1 year after transplantation.

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Defining unacceptable HLA antigens

Cited by 41 publications

References 45 publications

Calculated PRA: Initial Results Show Benefits for Sensitized Patients and a Reduction in Positive Crossmatches

Calculated PRA: Initial Results Show Benefits for Sensitized Patients and a Reduction in Positive Crossmatches

Luminex and antibody detection in kidney transplantation

Challenges in Treatment of Renal Graft Acute Antibody-Mediated Rejection

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