Abstract

Introduction: In India, patients of renal failure are dependent on live related or unrelated donor. Because of poor financial condition patients do not go for DSA (Donor Specific Antibody) detection using Luminex. In absence of screening of de-novo production of DSA and don’t get proper management. As a result of which patient undergo acute rejection.


Case Series: Here we are presenting 5 acute rejection cases comparing there DSA in pre-transplant and post-transplant sera using solid-phase assays.5 renal transplanted patients undergone acute and hyperacute rejection (Banff's classification) were considered for presented case series. Collected serum (pre and post-transplant on day of rejection) from each patient was subjected to detection of anti-HLA antibody using Luminex-PRA.


Conclusion: Presence of donor-specific anti-HLA antibody with their titer was detected in pre and post-transplant serum. It is found that the strength of DSA is directly proportional to graft life.

Keywords: Renal Transplant Anti-HLA antibodies Donor Specific Antibody

References

  1. Worthington JE, Martin S, Al-Husseini DM, Dyer PA, Johnson RWG. Posttransplantation production of donor HLA-specific antibodies as a predictor of renal transplant outcome. Transplantation. 2003;75(7):1034–40.
  2. Murphey CL, Forsthuber TG. Trends in HLA antibody screening and identification and their role in transplantation. Expert Rev Clin Immunol. 2008;4(3):391–9.
  3. Lefaucheur C, Loupy A, Hill GS, Andrade J, Nochy D, Antoine C, et al. Preexisting donor-specific HLA antibodies predict outcome in kidney transplantation. J Am Soc Nephrol [Internet]. 2010;21(8):1398–406. Available from: http://www.ncbi.nlm.nih.gov/pubmed/20634297%0Ahttp://www.pubmedcentral.nih.gov/articlerender.fcgi?artid=PMC2938596
  4. Zeevi A, Lunz J, Feingold B, Shullo M, Bermudez C, Teuteberg J, et al. Persistent strong anti-HLA antibody at high titer is complement binding and associated with increased risk of antibody-mediated rejection in heart transplant recipients. J Heart Lung Transplant [Internet]. 2013;32(1):98–105. Available from: http://dx.doi.org/10.1016/j.healun.2012.09.021
  5. Mizutani K, Terasaki P, Hamdani E, Esquenazi V, Rosen A, Miller J, et al. The importance of anti-HLA-specific antibody strength in monitoring kidney transplant patients. Am J Transplant. 2007;7(4):1027–31.
  6. Peña JRA, Saidman SL. Anti-HLA antibody testing in hematology patients. Am J Hematol. 2015;90(4):361–4.
  7. Lefaucheur C, Viglietti D, Bentlejewski C, Duong van Huyen J-P, Vernerey D, Aubert O, et al. IgG donor-specific Anti-Human HLA Antibody Subclasses and Kidney Allograft Antibody-Mediated Injury. J Am Soc Nephrol [Internet]. 2016;27(1):293–304. Available from: http://www.jasn.org/cgi/doi/10.1681/ASN.2014111120

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