Major histocompatibility complex class I–related chain A allele mismatching, antibodies, and rejection in renal transplantation

Cox, S.T.; Stephens, Henry A.F.; Fernando, R.; Karasu, Aliyye; Harber, Mark; Howie, Alexander J.; Powis, Stephen H.; Zou, Yizhou; Šťastný, Peter; Madrigal, J. Alejandro; Little, A.‐M.

doi:10.1016/j.humimm.2011.05.004

Cited by 53 publications

(49 citation statements)

References 44 publications

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“…It has been reported that the presence of antibodies towards MICA (Major histocompatibility complex class I-related Chain A) antigens in patients could be correlated with graft rejection [22]. However, in contrast to the effect of anti-HLA class I antibodies, we found that anti-MICA antibodies neither provoked development of TV in our animal model, nor induced SMC proliferation in vitro [18].…”

Section: Alloantigens On Vascular Cellscontrasting

confidence: 82%

Mechanisms of human smooth muscle cell proliferation and transplant vasculopathy induced by HLA class I antibodies: In vitro and in vivo studies

2012

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Section: Alloantigens On Vascular Cellscontrasting

confidence: 82%

Mechanisms of human smooth muscle cell proliferation and transplant vasculopathy induced by HLA class I antibodies: In vitro and in vivo studies

2012

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“…Furthermore, posttransplantation anti-MICA antibody development is related to greater rate of rejection and graft failure. Presence of anti-MICA antibodies could be an important diagnostic marker of rejection, suggesting a pivotal role for their identification and monitoring [39,40].…”

Section: Mica Antibodiesmentioning

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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“…1,4,6,7 Several recent reports have described the role of MICA and other non-HLA antibodies in the pathogenesis of ABMR in renal and cardiac transplants. [7][8][9][10] Several factors affect the likelihood of developing ABMR and subsequent early graft failure. These factors include the presence and peak strength of class 1 and class 2 donor-specific antibodies before transplant, previously formed MICA antibodies, positive historical crossmatch (either isolated or associated with any of the anti-HLA antibodies), and anti-non-HLA donor-specific antibodies.…”

Section: Introductionmentioning

confidence: 99%

“…With recent Major and minor histocompatibilty complex non-HLA antibodies Anti-MICA antibodies Anti-MICB antibodies Anti-angiotensin 2 receptor antibodies Anti-endothelial cell antibodies Anti-platelet antibodies Anti-glomerular basement membrane antibodies evidence about the negative effect of anti-MICA antibodies on graft outcome, more transplant centers are measuring these antibodies before and after transplant, especially in previously sensitized patients or recipients with unexplained graft dysfunction. 4,5,9,10 Anti-HLA antibodies are determined by measuring PRA by complement-dependent cytotoxic techniques or a solid-phase assay using either enzyme-linked immunosorbent assay or flow cytometry, which is a more sensitive technique. Although PRA level, measured by enzyme-linked immunosorbent assay or flow cytometry, is an estimate of previously formed HLA antibodies, flow cytometry (Luminex, Austin, TX USA) single antigen donor-specific antibody assay, a multiple beads-based technology that is not yet available in many countries, offers a more sensitive and accurate tool to assess the type and the strength of each donor-specific antibody.…”

Section: Introductionmentioning

confidence: 99%

“…Although PRA level, measured by enzyme-linked immunosorbent assay or flow cytometry, is an estimate of previously formed HLA antibodies, flow cytometry (Luminex, Austin, TX USA) single antigen donor-specific antibody assay, a multiple beads-based technology that is not yet available in many countries, offers a more sensitive and accurate tool to assess the type and the strength of each donor-specific antibody. 4,9,11,17 A shortcoming of the Luminex test is the lack of information about whether antibodies identified by Luminex can activate complement and harm the allograft. 4 Crossmatches of both B and T cells between recipient-donor pairs are determined with 2 complementary techniques: complement-dependent cytotoxic and flow cytometry assays (the latter being more sensitive) provide a negative cutoff and allow the assessment of crossmatch strength.…”

Section: Introductionmentioning

confidence: 99%

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Approach to Kidney Transplant in Sensitized Potential Transplant Recipients

Barbari

Abbas²,

Jaafar³

2012

Exp Clin Transplant

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More than one-third of patients on waiting lists for kidney transplant are sensitized. Most have previously formed donor-specific and non-donorspecific serum antibodies and/or positive crossmatch by complement-dependent cytotoxity and/or flow cytometry. Two categories of alloantibodies include antibodies against major histocompatibility complex human leukocyte antigen class 1 and class 2 and antibodies against minor histocompatibility complex. A current positive crossmatch is an absolute contraindication for transplant. Positive historical panel reactive antibody and/or donor-specific antibodies (human leukocyte antigen and minor histocompatibility complex), even in the absence of a historical positive crossmatch, are associated with an increased risk for allosensitization, antibodymediated rejection, and accelerated graft failure. Desensitization protocols are numerous, complex, and expensive. It is recommended to perform a systematic determination of historical and current panel reactive antibody, donor-specific antibodies (human leukocyte antigen and minor histocompatibility complex), and crossmatch by the most sensitive assays. The risk of sensitization may be estimated from the combined results of the crossmatch with the donor and those of the recipient's panel reactive antibody and donor-specific antibodies at baseline. The adoption of a scoring system for risk stratification may facilitate the task of organ allocation for sensitized patients. Recipients with an estimated sensitization risk ≥ high may be referred preferably to the national waiting priority list and informed about the financial and the medical risks that may incur with future transplant. Sensitized patients at high risk for antibody-mediated rejection may benefit from a structured monitoring process involving systematic and regular immunologic, histologic, and functional assessments of the graft after transplant. We recommend the adoption and regular updating of these approaches to ensure safe and appropriate therapeutic standards in these sensitized patients, in accordance with best clinical practice.

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Major histocompatibility complex class I–related chain A allele mismatching, antibodies, and rejection in renal transplantation

Cited by 53 publications

References 44 publications

Mechanisms of human smooth muscle cell proliferation and transplant vasculopathy induced by HLA class I antibodies: In vitro and in vivo studies

Mechanisms of human smooth muscle cell proliferation and transplant vasculopathy induced by HLA class I antibodies: In vitro and in vivo studies

Luminex and antibody detection in kidney transplantation

Approach to Kidney Transplant in Sensitized Potential Transplant Recipients

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