Pre-transplant AT 1 R antibodies correlate with early allograft rejection

Gareau, Alison J.; Wiebe, Chris; Pochinco, Denise; Gibson, Ian W.; Ho, Julie; Rush, David; Nickerson, Peter

doi:10.1016/j.trim.2017.12.001

Cited by 50 publications

(60 citation statements)

References 27 publications

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“…We report the case of a patient who was desensitized to remove high-strength non-HLA antibody and underwent a successful deceased donor kidney transplant. Non-HLA antibodies are increasingly being recognized as entities that can cause antibody-mediated rejection and lead to accelerated graft loss [14,17]. In this patient, CDC crossmatches with numerous prior deceased donor offers were repeatedly positive.…”

Section: Discussionmentioning

confidence: 84%

“…Antiendothelial cell antibody (AECA) and antibody directed against the angiotensin II type 1 receptor (AT1R) are among the best characterized non-HLA antibodies [10]. A mounting body of evidence points to the association of non-HLA anti-body with risk for rejection and overall poorer long-term outcomes posttransplant [5,6,8,[11][12][13][14][15][16][17][18][19].…”

Section: Introductionmentioning

confidence: 99%

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Successful A2 to B Deceased Donor Kidney Transplant after Desensitization for High-Strength Non-HLA Antibody Made Possible by Utilizing a Hepatitis C Positive Donor

Karpel

Ali

Lawson

et al. 2020

Case Reports in Transplantation

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Desensitization using plasma exchange can remove harmful antibodies prior to transplantation and mitigate risks for hyperacute and severe early acute antibody-mediated rejection. Traditionally, the use of plasma exchange requires a living donor so that the timing of treatments relative to transplant can be planned. Non-HLA antibody is increasingly recognized as capable of causing antibody-mediated renal allograft rejection and has been associated with decreased graft longevity. Our patient had highstrength non-HLA antibody deemed prohibitive to transplantation without desensitization, but no living donors. As the patient was eligible to receive an A2 ABO blood group organ and was willing to accept a hepatitis C positive donor kidney, this afforded a high probability of receiving an offer within a short enough time frame to attempt empiric desensitization in anticipation of a deceased donor transplant. Fifteen plasma exchange treatments were performed before the patient received an organ offer, and the patient was successfully transplanted. Hepatitis C infection was treated posttransplant. No episodes of rejection were observed. At one-year posttransplant, the patient maintains good graft function. In this case, willingness to consider nontraditional donor organs enabled us to mimic living donor desensitization using a deceased donor.

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Section: Discussionmentioning

confidence: 84%

Section: Introductionmentioning

confidence: 99%

Successful A2 to B Deceased Donor Kidney Transplant after Desensitization for High-Strength Non-HLA Antibody Made Possible by Utilizing a Hepatitis C Positive Donor

Karpel

Ali

Lawson

et al. 2020

Case Reports in Transplantation

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“…AT 1 R antibodies may interplay with HLA antibodies. The presence of AT 1 R antibodies pre‐transplant is an independent risk factor for the development of de novo HLA DSAs (Cuevas et al., 2016;Gareau et al., 2018). AT 1 R antibodies can substantiate the impact of HLA antibodies on graft function.…”

Section: Antibodies Against Angiotensin II Type 1 Receptor (At1r)mentioning

confidence: 99%

Impact and production of Non‐HLA‐specific antibodies in solid organ transplantation

Zhang

Reinsmoen

2020

Int J Immunogenetics

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Abbreviations: AT 1 R, angiotensin II type 1 receptor; DSA, donor-specific antibody;ELISA, enzyme-linked immunosorbent assay; ET A R, endothelin type A receptor; FSGS, focal segmental glomerulosclerosis; GPCR, G protein-coupled receptor; HLA, human leucocyte antigen. AbstractOrgan transplantation is an effective way to treat end-stage organ disease. Extending the graft survival is one of the major goals in the modern era of organ transplantation. However, long-term graft survival has not significantly improved in recent years despite the improvement of patient management and advancement of immunosuppression regimen. Antibody-mediated rejection is a major obstacle for long-term graft survival. Donor human leucocyte antigen (HLA)-specific antibodies were initially identified as a major cause for antibody-mediated rejection. Recently, with the development of solid-phase-based assay reagents, the contribution of non-HLA antibodies in organ transplantation starts to be appreciated. Here, we review the role of most studied non-HLA antibodies, including angiotensin II type 1 receptor (AT 1 R), K-α-tubulin and vimentin antibodies, in the solid organ transplant, and discuss the possible mechanism by which these antibodies are stimulated. K E Y W O R D SAT 1 R, collagen V, HLA, K-α1-tubulin, non-HLA antibody, transplant, vimentin How to cite this article: Zhang X, Reinsmoen NL. Impact and production of Non-HLA-specific antibodies in solid organ transplantation. Int J Immunogenet. 2020;47:235-242.

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“…This is acknowledged by companies producing reagents for HLA antibody detection which recently both developed a Luminex‐based multiplex assay for detection of non‐HLA antibodies. Reports are currently emerging on the clinical significance of these non‐HLA antibodies (or autoantibodies) using these commercial assays . In these reports, antibodies of the IgG isotype are measured, whereas it is possible that some non‐HLA antibodies relevant to prognosis are of another isotype and are missed.…”

Section: Non‐hla Antibodies In Kidney Transplantationmentioning

confidence: 99%

Results and reflections from the PROfiling Consortium on Antibody Repertoire and Effector functions in kidney transplantation: A mini‐review

Kamburova

Hoitsma

Claas

et al. 2019

HLA

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Kidney transplantation is the best treatment option for patients with end‐stage renal disease (ESRD). The waiting time for a deceased donor kidney in the Netherlands is approximately 3 years. Mortality among patients on the waiting list is high. The aim of the PROCARE consortium (PROfiling Consortium on Antibody Repertoire and Effector functions) was to decrease the waiting time by providing a matching algorithm yielding a prolonged graft survival and less HLA‐immunization compared with the currently used Eurotransplant Kidney allocation system. In this study, 6097 kidney transplants carried out between January 1995 and December 2005 were re‐examined with modern laboratory techniques and insights that were not available during that time period. In this way, we could identify potential new parameters that can be used to improve the matching algorithm and prolong graft survival. All eight University Medical Centers in the Netherlands participated in this multicenter study. To improve the matching algorithm, we used as central hypothesis that the combined presence of class‐I and ‐II single‐antigen bead (SAB)‐defined donor‐specific HLA antibodies (DSA) prior to transplantation, non‐HLA antibodies, the number of B‐ and/or T‐cell epitopes recognized on donor HLA, and specific polymorphisms in effector mechanisms of IgG were associated with an increased risk for graft failure. The purpose of this article is to relate the results obtained from the PROCARE consortium study to other studies published in recent years. The clinical relevance of SAB‐defined DSA, complement‐fixing DSA, non‐HLA antibodies, and the effector functions of (non)‐HLA‐antibodies will be discussed.

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Pre-transplant AT 1 R antibodies correlate with early allograft rejection

Cited by 50 publications

References 27 publications

Successful A2 to B Deceased Donor Kidney Transplant after Desensitization for High-Strength Non-HLA Antibody Made Possible by Utilizing a Hepatitis C Positive Donor

Successful A2 to B Deceased Donor Kidney Transplant after Desensitization for High-Strength Non-HLA Antibody Made Possible by Utilizing a Hepatitis C Positive Donor

Impact and production of Non‐HLA‐specific antibodies in solid organ transplantation

Results and reflections from the PROfiling Consortium on Antibody Repertoire and Effector functions in kidney transplantation: A mini‐review

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