Clinical and anti-HLA antibody profile of nine renal transplant recipients with failed grafts: donor-specific and non-donor-specific antibody development.

摘要: This study applied the single antigen microsphere technology to retrospective analysis of sequential post-transplant serum samples in context patient's clinical course. Detailed information on nine patients was presented as representative larger cohort and illustrative different patterns anti-HLA antibody development scenarios that culminated graft failure. Our major observations are summarized follows: 1. These data confirm high sensitivity bead method: In some patients, DSA NDSA were undetected by standard methods found pre-transplant samples. 2. The precise role plays a particular rejection complicated cases which humoral is not diagnosed biopsy: possible involvement ADCC mechanisms involving an indirect for process should be carefully investigated. 3. Although antibodies associated with rejection, time interval between detection can vary dramatically patients. Both adsorbed erratically detected circulation, remaining until nephrectomy. 4. Anti-HLA strengths often fluctuate widely over course, de novo generally greater strength than NDSA. 5. addition DSA, we have observed consistent induction diverse, cross-reactive occurs only during course but also after failure, when immunosuppression tapered prior support further studies evaluate value prospective monitoring better understand place acute rejection. may improve our ability reverse episodes. Since has been considered predictor late loss via chronic allograft nephropathy, understanding modifying response critical extending longevity transplanted organs. Finally, since strong sensitization will seriously hamper identify compatible donor future transplant, these reinforce importance minimizing HLA mismatches recipient.