Serum analysis after transplant nephrectomy reveals restricted antibody specificity patterns against structurally defined HLA class I mismatches

Adeyi, Oyedele; Girnita, Alin; Howe, Judy; Marrari, Marilyn; Awadalla, Yehia; Askar, Medhat; Martell, Joan; Zeevi, A.; Shapiro, Ron; Nalesnik, Michael A.; Randhawa, Parmjeet; Demetris, Anthony J.; Duquesnoy, René J.

doi:10.1016/j.trim.2005.01.001

Cited by 95 publications

(58 citation statements)

References 30 publications

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“…Similarly, Lederer et al 8 found that 11/25 (44%) of specimens with positive peritubular capillary C4d staining were not associated with donor-specific antibodies. Potential explanations include technical issues, different approaches for peritubular capillary C4d staining evaluation and scoring, complete absorbance of high affinity antibodies by allograft tissue 22 and non-HLA antibodies, which would not be detected during routine testing of donor-specific antibody. 24 In our study, the latter two possibilities are supported by the fact that diffuse C4d was associated with inferior outcome even in the absence of demonstrable donorspecific antibodies (three of six grafts lost).…”

Section: Discussionmentioning

confidence: 99%

“…All positive circulating donor-specific antibodies were detected within 8 days of the biopsy except in two cases, one of them was performed 16 days before biopsy, whereas the other was positive 160 days before biopsy, following which it became negative, possibly due to allograft absorbance. 22 Clinical and pathologic parameters were obtained by retrospective blinded chart review in accordance with methods approved by the University of Pittsburgh Institutional Review Board (IRB protocol no. 602112).…”

Section: Circulating Donor-specific Antibodiesmentioning

confidence: 99%

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Clinical significance of the distribution of C4d deposits in different anatomic compartments of the allograft kidney

et al. 2008

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Section: Discussionmentioning

confidence: 99%

Section: Circulating Donor-specific Antibodiesmentioning

confidence: 99%

Clinical significance of the distribution of C4d deposits in different anatomic compartments of the allograft kidney

et al. 2008

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“…Presumably this DTH response represents a T cell effector response directed at the graft and a T cell helper response for generating alloreactive antibodies. Adeyi et al [16] evaluated alloantibody specificities in the serum of 27 recipients of kidney transplants who underwent removal of their transplants. Before nephrectomy, 11% of renal allograft recipients had detectable antibodies specific for the donor; after nephrectomy 97% (26 of 27 subjects) had detectable levels of antibodies directed against donor HLA.…”

Section: Accommodation In Clinical Transplantationmentioning

confidence: 99%

Accommodation of grafts: Implications for health and disease

Tang

Platt

2007

Human Immunology

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Accommodation refers to the acquired resistance of a graft to immune-mediated injury. It is typically observed after antibodies that would cause rejection of a graft are removed from a recipient and then return. Besides being a condition so induced, accommodation can occur spontaneously, without the depleting of antibodies. Indeed, we postulate that spontaneous accommodation may be the most common outcome of clinical organ transplantation. This communication will review the current understanding of accommodation, emphasizing recent advances and important questions. Among the recent advances are the discoveries of potentially broader relevance of accommodation for biology and immunology and pathways by which accommodation may be achieved. To investigate these pathways and to understand how accommodation begins and how it evolves, clinical organ transplants might offer a useful and incisive model.

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“…After the graft removal, 73% of the sera contained DSA. In a study of sera of 27 patients who had rejected a kidney transplant, circulating DSA were found by cytotoxicity tests in three (11%) cases before and in 26 (97%) cases after allograft nephrectomy (27).…”

Section: Dsamentioning

confidence: 99%