Donor-specific B cell memory in alloimmunized kidney transplant recipients: first clinical application of a novel method
| Autor: | Wehmeier, C., Karahan, G.E., Krop, J., Vaal, Y. de, Langerak-Langerak, J., Binet, I., Schaub, S., Roelen, D.L., Claas, F.H.J., Heidt, S., Swiss Transplant Cohort Study |
|---|---|
| Jazyk: | angličtina |
| Rok vydání: | 2020 |
| Předmět: |
Graft Rejection
Male medicine.medical_specialty Biopsy Pilot Projects 030230 surgery Peripheral blood mononuclear cell Kidney transplant Gastroenterology Risk Assessment 03 medical and health sciences 0302 clinical medicine Antigen HLA Antigens Isoantibodies Internal medicine medicine Humans Kidney transplantation B cell Retrospective Studies Transplantation B-Lymphocytes medicine.diagnostic_test business.industry Incidence (epidemiology) Histocompatibility Testing Incidence Retrospective cohort study Middle Aged medicine.disease Kidney Transplantation Tissue Donors body regions medicine.anatomical_structure 030211 gastroenterology & hepatology Female business Immunologic Memory Switzerland Follow-Up Studies |
| Zdroj: | Transplantation, 104(5), 1026-1032. LIPPINCOTT WILLIAMS & WILKINS |
| Popis: | Background.HLA-specific memory B cells may contribute to the serum HLA antibody pool upon antigen reexposure. The aim of this pilot study was to investigate the presence of concurrent donor-specific memory B cell-derived HLA antibodies (DSA-M) in renal allograft recipients with pretransplant donor-specific HLA antibodies (DSA) and its association with occurrence of antibody-mediated rejection (AMR) using a recently developed method.Methods.Twenty patients with Luminex single antigen bead (SAB) assay-defined DSA but negative complement-dependent cytotoxicity crossmatches were enrolled. Plasma samples and peripheral blood mononuclear cells were collected at 3 timepoints (pretransplant, mo 6, mo 12). We analyzed IgG-purified and concentrated culture supernatants from polyclonally activated peripheral blood mononuclear cells using SAB assays and compared HLA antibody profiles with same day plasma results.Results.Plasma SAB analysis revealed 35 DSA in 20 patients pretransplant. DSA-M were detected in 9 of 20 (45%) patients and for 10 of 35 specificities (29%). While median mean fluorescence intensity values of DSA with concurrent DSA-M (5877) were higher than those of DSA without DSA-M (1476), 3 of 6 patients with AMR and low mean fluorescence intensity DSA (= 1 + ptc >= 1) of microvascular inflammation (67% vs 9%, P = 0.02). In 17 patients (28 DSA) with posttransplant analyses, persisting DSA posttransplant had more often DSA-M (6/12; 50%) than nonpersisting DSA (2/16; 13%).Conclusions.Assessment of DSA-M might be a novel tool to supplement serum HLA antibody analysis for pretransplant risk stratification in patients with DSA. |
| Databáze: | OpenAIRE |
| Externí odkaz: |
|