Subtypes of immunoglobulin (Ig)-G antibodies against donor class II HLA and cross-match results in three kidney transplant candidates
Subtypes of immunoglobulin (Ig)-G antibodies against donor class II HLA and cross-match results in three kidney transplant candidates
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DOI：
10.1016/j.trim.2010.03.003
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发表时间：
2010-05-01
影响因子：
1.5
通讯作者：
Higgins, N.
中科院分区：
文献类型：
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作者：
Lobashevsky, A.;Rosner, K.;Higgins, N.
预先存在的供体特异性抗体（DSA）在实体器官移植的成功中起着关键作用。供体淋巴细胞和受体血清之间的交叉配型（CM）是检测这些抗体的关键方法。基于Luminex平台的抗人类白细胞抗原（HLA）抗体固相分析方法彻底改变了抗体检测和HLA特异性鉴定的方法。在这项研究中，我们报告了三例成功的活体供肾移植对强阳性B淋巴细胞流式细胞术（FC）CM由于高反应性DSA直接HLA II类。IgG固相亚型分析表明，超过50%的这些抗体由非补体结合IgG 2/IgG 4亚型代表。这些发现解释了这些患者中无抗体介导的排斥反应（AMR）的长期移植后病程，尽管DSA水平较高。因此，我们的结论是，常规应用单HLA包被珠（SAB）IgG亚型检测可能会提供新的见解移植或脱敏的患者呈现阴性B细胞补体依赖性细胞毒性（CDC）和阳性FC CM。(C)2010 Elsevier B. V.保留所有权利。
Preexisting donor-specific antibodies (DSA) play a critical role in the success of solid-organ transplantation. Cross-match (CM) between donor lymphocytes and recipient serum is a pivotal methodology for detecting these antibodies. Luminex platform based solid-phase methodology for anti-human leukocyte antigen (HLA) antibody analysis has revolutionized the approach to antibody detection and HLA specificity identification. In this study, we have reported three cases of successful living donor kidney transplantations performed against strongly positive B lymphocyte flow cytometry (FC) CM owing to highly reactive DSA directed to HLA class II. IgG solid-phase subtype analysis showed that more than 50% of these antibodies were represented by non-complement binding IgG2/IgG4 subtypes. These findings account for antibody mediated rejection (AMR) free long-term post-transplant course in these patients despite, the high level of DSA. Thus, we conclude that routine application of single HLA-coated beads (SAB) IgG subtype assay may provide new insights regarding transplantation or desensitization of patients presenting with negative B-cell complement dependent cytotoxic (CDC) and positive FC CM. (C) 2010 Elsevier B.V. All rights reserved.