scholarly journals Antibody-Mediated Rejection and Sponge Effect in a Redo Lung Transplant Recipient

2021 ◽  
Vol 2021 ◽  
pp. 1-4
Author(s):  
Ashwini Arjuna ◽  
Michael T. Olson ◽  
Sofya Tokman ◽  
Rajat Walia ◽  
Thalachallour Mohanakumar ◽  
...  
Keyword(s):  
Transplant Recipient ◽  
Lung Transplant ◽  
Human Leukocyte ◽  
Lung Transplant Recipient ◽  
Term Survival ◽  
Antibody Mediated Rejection ◽  
Leukocyte Antigens ◽  
Allograft Failure ◽  
Donor Specific Antibodies

Long-term survival after lung transplant remains severely limited by chronic lung allograft dysfunction. Antibody-mediated rejection of lung transplant allografts is usually caused by donor-specific antibodies (DSAs) directed toward donor human leukocyte antigens (HLAs). Typically, patients with antibody-mediated rejection have significantly higher circulating DSAs and increased mean fluorescence intensity than those without antibody-mediated rejection. However, some patients with antibody-mediated rejection have low mean fluorescence intensities, partly due to the “sponge effect” related to DSAs binding to HLA molecules within the lung. Herein, we report the case of an 18-year-old, female lung transplant recipient who required retransplantation and developed circulating DSAs directed toward the first allograft but detected in circulation only after retransplantation. The present case draws attention to a rare finding of sponge effect in a patient with antibody-mediated rejection leading to allograft failure.

Elderly Lung Transplant Recipient Long-Term Survival Is Not Impacted By Donor Age

2015 ◽  
Vol 34 (4) ◽  
pp. S245-S246
Author(s):  
B.A. Whitson ◽  
Y. Ravi ◽  
A. Pope-Harman ◽  
A. Kilic ◽  
J.D. Tobias ◽  
...  
Keyword(s):  
Transplant Recipient ◽  
Lung Transplant ◽  
Lung Transplant Recipient ◽  
Donor Age ◽  
Term Survival ◽  
Long Term Survival

scholarly journals Optimal Immunosuppression Strategy in the Sensitized Kidney Transplant Recipient

2021 ◽  
Vol 10 (16) ◽  
pp. 3656
Author(s):  
Danae Olaso ◽  
Miriam Manook ◽  
Dimitrios Moris ◽  
Stuart Knechtle ◽  
Jean Kwun
Keyword(s):  
Immune Response ◽  
Transplant Recipient ◽  
Kidney Transplant Recipient ◽  
Human Leukocyte ◽  
Immunosuppressive Regimen ◽  
Human Leukocyte Antigens ◽  
Donor Pool ◽  
Hla Antibodies ◽  
Antibody Mediated Rejection ◽  
Leukocyte Antigens

Patients with previous sensitization events against anti-human leukocyte antigens (HLA) often have circulating anti-HLA antibodies. Following organ transplantation, sensitized patients have higher rates of antibody-mediated rejection (AMR) compared to those who are non-sensitized. More stringent donor matching is required for these patients, which results in a reduced donor pool and increased time on the waitlist. Current approaches for sensitized patients focus on reducing preformed antibodies that preclude transplantation; however, this type of desensitization does not modulate the primed immune response in sensitized patients. Thus, an optimized maintenance immunosuppressive regimen is necessary for highly sensitized patients, which may be distinct from non-sensitized patients. In this review, we will discuss the currently available therapeutic options for induction, maintenance, and adjuvant immunosuppression for sensitized patients.

Antibody-mediated rejection in a lung transplant recipient after acute stroke

2012 ◽  
Vol 27 (4) ◽  
pp. 171-174 ◽  
Author(s):  
Don Hayes ◽  
Nicholas DiPaola ◽  
Peter B. Baker ◽  
Stephen Kirkby ◽  
Alistair B. Phillips ◽  
...  
Keyword(s):  
Transplant Recipient ◽  
Acute Stroke ◽  
Lung Transplant ◽  
Lung Transplant Recipient ◽  
Antibody Mediated Rejection

scholarly journals Long-term survival of the transplanted kidney and the clinical relevance of donor-specific antibodies

2020 ◽  
Vol 3 (1) ◽  
pp. 17-22
Author(s):  
Eva Svobodova ◽  
Sarka Valhova ◽  
Ondrej Viklicky ◽  
Ilja Striz ◽  
Jelena Skibova ◽  
...  
Keyword(s):  
Graft Survival ◽  
Solid Phase ◽  
Kidney Graft ◽  
Term Survival ◽  
Specific Antibodies ◽  
Antibody Mediated Rejection ◽  
Number Of Patients ◽  
Single Antigen ◽  
Donor Specific Antibodies

The aim of our study was to evaluate the relevance of donor-specific antibodies (DSA) as defined by solid-phase single-antigen (SA) assays for predicting long-term graft survival after kidney transplantation. Sera from 132 kidney transplant recipients were retrospectively tested before, 3, 6 and 12 months after transplantation. The incidence of rejection and graft survival was followed up for 7 years. We found 29 episodes of acute cellular rejection (CR), 21 cases of antibody-mediated rejection (AMR) and 18 graft failures due to immunological reasons. Pre-transplant DSA and DSA three months after transplantation correlated with an increased rate of AMR and impaired graft function. After the fourth year, recipients with persistent DSA were at a higher risk of graft failure (p = 0.0317). Antibody specificity was prevailingly to HLA class I antigens (66.6% DSA, 75% non-DSA). During the first year after transplantation, the number of patients with non-DSA decreased (30.3% to 10.7%), while, due to de novo production of antibodies, the number of DSA positive patients remained constant. Conclusion: Detection of antibodies to HLA antigens using solid-phase assays, especially single-antigen bead technology before and three months after transplantation is predictive for increased incidence of antibody-mediated rejection and impaired long-term kidney graft survival.

scholarly journals Clinical Case: Patient with Mixed Graft Rejection Four Days after Kidney Transplantation Developed Specific Antibodies against Donor Bw4 Specificities

Antibodies ◽  
2021 ◽  
Vol 10 (3) ◽  
pp. 28
Author(s):  
Claudia M. Muñoz-Herrera ◽  
Juan Francisco Gutiérrez-Bautista ◽  
Miguel Ángel López-Nevot
Keyword(s):  
Kidney Transplantation ◽  
Graft Rejection ◽  
Human Leukocyte ◽  
Case Patient ◽  
Specific Antibodies ◽  
Antibody Mediated Rejection ◽  
Leukocyte Antigens ◽  
Hla Genotypes ◽  
Donor Specific Antibodies ◽  
Hla Genotype

Kidney transplantation, like other transplants, has the risk of producing graft rejection due to genetic differences between donor and recipient. The three known types of renal rejection are listed in the Banff classification: T-cell-mediated rejection (TCMR), antibody-mediated rejection (ABMR), and mixed rejection. The human leukocyte antigens (HLA) are highly polymorphic and may be the targets of donor-specific antibodies, resulting in ABMR. Therefore, prior to transplantation, it is necessary to analyze the HLA genotype of the donor and recipient, as well as the presence of DSA, in order to avoid hyperacute rejection. However, due to the shortage of kidneys, it is very difficult to find a donor and a recipient with completely matched HLA genotypes. This can trigger a future rejection of the kidney, as is reported in this work. We describe a patient who received a kidney transplant after a negative DSA test, who developed graft rejection with antibodies against the donor’s HLA-Bw4 public epitope and lymphocytic infiltrate four days after transplantation, whose differential diagnosis was mixed rejection.

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