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PredicateObject
rdf:type
lifeskim:mentions
pubmed:issue
8
pubmed:dateCreated
2009-8-11
pubmed:abstractText
Presensitization of donor human leukocyte antigens (HLA) demonstrated through a positive crossmatch is detrimental to allograft function and best avoided through donor exclusion. The clinical significance of alloantibody detectable by sensitive solid-phase assay is not completely defined and is the focus of this study. Pretransplant sera from 64 consecutive living-donor renal transplant recipients were screened by enzyme-linked immunosorbent assay (ELISA) and Luminex assays. Results were analyzed for correlation with clinical outcome. Luminex proved more sensitive than ELISA for alloantibody detection, with three identifiable patterns. Twenty-eight patients were antibody negative, 24 had non-donor-specific antibody (non-DSA), and 12 had donor-specific antibody (DSA). The highest number of rejections (n = 4) and graft losses (n = 6) occurred in the antibody-negative group. The non-DSA group had two graft losses, as did the DSA group. The two graft losses in the DSA group were caused by recurrent focal segmental glomerulosclerosis (FSGS) at 35 months and death with a functioning graft at 32 months. Overall, there were no cases of antibody-mediated rejection and allograft function to 4 years was comparable among all three groups. Under our standard immunosuppression protocol and crossmatch criteria for histocompatibility, alloantibody detectable by Luminex was not detrimental to successful living-donor transplantation.
pubmed:language
eng
pubmed:journal
pubmed:citationSubset
IM
pubmed:chemical
pubmed:status
MEDLINE
pubmed:month
Aug
pubmed:issn
1879-1166
pubmed:author
pubmed:issnType
Electronic
pubmed:volume
70
pubmed:owner
NLM
pubmed:authorsComplete
Y
pubmed:pagination
584-8
pubmed:meshHeading
pubmed-meshheading:19477211-Adult, pubmed-meshheading:19477211-Aged, pubmed-meshheading:19477211-Aged, 80 and over, pubmed-meshheading:19477211-Antibody Formation, pubmed-meshheading:19477211-Diagnostic Errors, pubmed-meshheading:19477211-Epitopes, pubmed-meshheading:19477211-Female, pubmed-meshheading:19477211-Graft Rejection, pubmed-meshheading:19477211-HLA Antigens, pubmed-meshheading:19477211-Humans, pubmed-meshheading:19477211-Immunization, pubmed-meshheading:19477211-Immunosorbent Techniques, pubmed-meshheading:19477211-Isoantibodies, pubmed-meshheading:19477211-Kidney Transplantation, pubmed-meshheading:19477211-Living Donors, pubmed-meshheading:19477211-Male, pubmed-meshheading:19477211-Microspheres, pubmed-meshheading:19477211-Middle Aged, pubmed-meshheading:19477211-Retrospective Studies, pubmed-meshheading:19477211-Risk Factors, pubmed-meshheading:19477211-Sensitivity and Specificity
pubmed:year
2009
pubmed:articleTitle
Living donor renal transplantation in the presence of donor-specific human leukocyte antigen antibody detected by solid-phase assay.
pubmed:affiliation
Barnes-Jewish Hospital, Department of Laboratories, One Barnes-Jewish Hospital Plaza, St. Louis, MO 63110, USA. dlp2368@bjc.org
pubmed:publicationType
Journal Article