Successful lung transplantation in the presence of pre-existing donor-specific cytotoxic HLA Class II antibodies
| Autor: | Bouke G. Hepkema, Wim van der Bij, Ilby Bouwman, Laura Bungener, Caroline Roozendaal, Simon P. M. Lems, Michiel E. Erasmus, Theo Jongsma, Annechien J. A. Lambeck, Wim Timens, Erik A M Verschuuren, Aad P. van den Berg |
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| Přispěvatelé: | Faculteit Medische Wetenschappen/UMCG, Cardiovascular Centre (CVC), Groningen Institute for Organ Transplantation (GIOT), Groningen Research Institute for Asthma and COPD (GRIAC), Guided Treatment in Optimal Selected Cancer Patients (GUTS) |
| Rok vydání: | 2012 |
| Předmět: |
Pulmonary and Respiratory Medicine
EXPRESSION Graft Rejection medicine.medical_treatment Flow cytometry PANEL-REACTIVE ANTIBODY Young Adult HISTOCOMPATIBILITY COMPLEX ANTIGENS HLA Antigens Isoantibodies LSA MHC class I medicine Cytotoxic T cell Lung transplantation Humans HLA antibody LIVER-KIDNEY TRANSPLANTATION POSITIVE CROSS-MATCH Tissue Survival Transplantation Lung biology medicine.diagnostic_test LYMPHOCYTOTOXIC ANTIBODIES business.industry FLOW-CYTOMETRY Panel reactive antibody donor-specific antibody Tissue Donors MHC CLASS-I RECIPIENTS medicine.anatomical_structure surgical procedures operative Treatment Outcome Immunology biology.protein Surgery Female Antibody rejection Cardiology and Cardiovascular Medicine business HYPERACUTE REJECTION Lung Transplantation |
| Zdroj: | Journal of Heart and Lung Transplantation, 31(12), 1301-1306. ELSEVIER SCIENCE INC |
| ISSN: | 1557-3117 1053-2498 |
| Popis: | Pre-existing HLA antibodies are a well-established causal factor for rejection and graft dysfunction after solid-organ transplantation. In lung transplant recipients, the significance of HLA antibodies has not been fully established. Although rare, several cases of hyperacute rejection of the lung allograft due to pre-existing donor-specific HLA antibodies have been described. In contrast, we describe successful lung transplantation in a patient with pre-existing donor-specific HLA antibodies. Routine screening prior to lung transplantation revealed cytotoxic HLA Class II antibodies, directed against the alpha chain of HLA-DQ, induced by a previous liver transplant. Due to clinical deterioration, it was decided to accept a lung offer without virtual crossmatching for DQ compatibility. Cytotoxic antibodies against the lung donor were confirmed retrospectively, resulting in strong positive B-cell crossmatches. Interestingly, the patient showed no clinical or histologic signs of rejection. This case demonstrates that the presence of high levels of pre-existing donor-specific HLA antibodies does not necessarily lead to rejection and graft failure. Although screening for antibodies prior to transplantation remains crucial, this study shows that we are thus far not able to predict the effect of pre-exis.ing HLA Class II antibodies on allograft survival in individual patients. J Heart Lung Transplant 2012; 31: 1301-6 (C) 2012 International Society for Heart and Lung Transplantation. All rights reserved. |
| Databáze: | OpenAIRE |
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