Kinetics of Cellular and Humoral Immunity in a Successful Case of Positive Crossmatch Kidney Transplantation: A Case Report

Tanimine, Naoki; Ide, Kentaro; Yamashita, Mitsuo; Tanaka, Yuka; Igarashi, Yuka; Banshodani, Masataka; Tazawa, Hirofumi; Basnet, Nabin Bahadur; Doskali, Marlen; Onoe, Takashi; Tashiro, Hirotaka; Ohdan, Hideki

doi:10.1016/j.transproceed.2011.05.039

Cited by 5 publications

(5 citation statements)

References 10 publications

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“…Of these, 19 patients were excluded from the study because of the presence of donor-specific anti-human leukocyte antigen Abs (DSAs) at the time of KT with/without usage of bortezomib (n = 5) [13,14], other organ transplantation (liver n = 1, lung n = 1), tertiary transplantation (n = 1), or incomplete immune monitoring data caused by limited volume of stored lymphocytes from donors for in vitro mixed lymphocyte reaction (MLR) assays (n = 11). The remaining 46 patients (18 ABO-I recipients and 28 ABO-C recipients) were enrolled in this study.…”

Section: Kt Recipientsmentioning

confidence: 99%

Different sensitivity of rituximab-treatment to B-cells between ABO-incompatible kidney and liver transplantation

et al. 2016

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A desensitization protocol with rituximab is currently widely used for kidney transplantation (KT) and liver transplantation (LT) across the ABO blood group-incompatible (ABO-I) barrier. However, it remains to be elucidated whether rituximab is equally effective for B-cell and T-cell immune responses in both KT and LT recipients. To clarify these effects of rituximab, we enrolled 46 KT and 77 LT recipients in this study. The proportion of peripheral blood B-cells was determined at the perioperative period. T-cell responses to allostimulation were evaluated by a mixed lymphocyte reaction (MLR) assay. One week after rituximab administration, peripheral B-cells became undetectable in ABO-I KT recipients but remained detectable in some of the ABO-I LT recipients; B-cells were undetectable in both groups by week 2. B-cells remained below the detection limit throughout the first year in the ABO-I KT recipients, whereas they reappeared in the periphery after 6months in the ABO-I LT recipients. There were no significant differences in alloreactive T-cell responses based on MLR analyses between ABO-I and ABO-compatible groups. This study indicates that rituximab has differing B-cell sensitivity between KT and LT recipients and a minimal effect on the alloreactive T-cell responses in KT and LT recipients.

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Section: Kt Recipientsmentioning

confidence: 99%

Different sensitivity of rituximab-treatment to B-cells between ABO-incompatible kidney and liver transplantation

et al. 2016

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“…The kidney transplant candidates, who had positive T-cell flow cytometry cross-match (T-FCXM) or immunocomplex capture fluorescence analysis (ICFA) class I results, received our conventional desensitization protocol as follows; that is, they received a single dose of rituximab (375 mg/m 2 ) combined with 3 double-filtration plasmapheresis (DFPP) sessions, followed by low doses (100 mg/kg per day) of IVIG (DFPP/low-IVIG). 10 Tacrolimus (target trough level: 5-10 ng/mL) or cyclosporine A (target trough level: 80-100 ng/ml) and mycophenolate mofetil (MMF, 20 mg/kg per day) were started 1 week before the DFPP/low-IVIG treatment. Three patients, in whom cross-match tests remained positive despite 3 DFPP/low-IVIG sessions, underwent the phased desensitization protocol.…”

Section: Methodsmentioning

confidence: 99%

“…The complement-dependent cytotoxicity cross-match and the T-FCXM were performed as previously reported. 10 As an alternative cross-match test, ICFA was performed according to the manufacturer's protocol (WAKFlow HLA Ab class I&II, Wakunaga Pharmaceutical Co., Ltd., Japan). A screening test dedicated to detecting antibodies against HLA class I and class II in addition to MHC class I–related chain A was performed on a Luminex platform (LABScan 100 Flow Analyzer; Luminex Corporation, Austin, TX) using LABScreen Mixed (One Lambda, Canoga Park, CA) according to the manufacturer's protocol.…”

Section: Methodsmentioning

confidence: 99%

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A Phased Desensitization Protocol With Rituximab and Bortezomib for Highly Sensitized Kidney Transplant Candidates

Ide

Tanaka

Sasaki

et al. 2015

Transplantation Direct

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“…We desensitized DSA-positive patients with rituximab and plasmapheresis, which was adopted from a protocol for ABO-blood type incompatible (ABO-I) transplant recipients 19 . We have recently shown that pretransplant desensitization with rituximab has a minimal effect on the alloreactive T cell responses by comparing ABO-I and ABO-compatible groups 20 .…”

Section: Introductionmentioning

confidence: 99%

B cell depletion with anti-CD20 mAb exacerbates anti-donor CD4+ T cell responses in highly sensitized transplant recipients

Tanaka

Ide

Tanaka

et al. 2021

Sci Rep

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Pretransplant desensitization with rituximab has been applied to preformed donor-specific anti-human leukocyte antigen antibody (DSA)-positive recipients for elimination of preformed DSA. We investigated the impact of pretransplant desensitization with rituximab on anti-donor T cell responses in DSA-positive transplant recipients. To monitor the patients’ immune status, mixed lymphocyte reaction (MLR) assays were performed before and after desensitization with rituximab. Two weeks after rituximab administration, the stimulation index (SI) of anti-donor CD4+ T cells was significantly higher in the DSA-positive recipients than in the DSA-negative recipients. To investigate the mechanisms of anti-donor hyper responses of CD4+ T cells after B cell depletion, highly sensitized mice models were injected with anti-CD20 mAb to eliminate B cells. Consistent with clinical observations, the SI values of anti-donor CD4+ T cells were significantly increased after anti-CD20 mAb injection in the sensitized mice models. Adding B cells isolated from untreated sensitized mice to MLR significantly inhibited the enhancement of anti-donor CD4+ T cell response. The depletion of the CD5+ B cell subset, which exclusively included IL-10-positive cells, from the additive B cells abrogated such inhibitory effects. These findings demonstrate that IL-10+ CD5+ B cells suppress the excessive response of anti-donor CD4+ T cells responses in sensitized recipients.

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Kinetics of Cellular and Humoral Immunity in a Successful Case of Positive Crossmatch Kidney Transplantation: A Case Report

Cited by 5 publications

References 10 publications

Different sensitivity of rituximab-treatment to B-cells between ABO-incompatible kidney and liver transplantation

Different sensitivity of rituximab-treatment to B-cells between ABO-incompatible kidney and liver transplantation

A Phased Desensitization Protocol With Rituximab and Bortezomib for Highly Sensitized Kidney Transplant Candidates

B cell depletion with anti-CD20 mAb exacerbates anti-donor CD4+ T cell responses in highly sensitized transplant recipients

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