Journal
TRANSPLANT INTERNATIONAL
Volume 24, Issue 2, Pages 150-157Publisher
WILEY-BLACKWELL PUBLISHING, INC
DOI: 10.1111/j.1432-2277.2010.01166.x
Keywords
anti-HLA antibody; donor-specific antibody; kidney transplantation; MESF; quantitative analysis
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Funding
- International Research and Educational Institute for Integrated Medical Sciences, Tokyo Women's Medical University
- Ministry of Education, Culture, Sports, Science and Technology (Japan)
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P>In this study, we retrospectively investigated the relationship between the presence/titers of donor-specific (DSA)/nondonor-specific antibody (NDSA) and the rate of graft rejection after transplantation. The subjects comprised 34 recipients who tested positive by FlowPRA (R) Screening. The recipients were divided into two groups; 22 recipients with DSA and 12 recipients with NDSA, as detected using FlowPRA (R) Single Antigen I and II beads. The antibodies were also quantitatively examined using the molecules of equivalent soluble fluorochrome (MESF) method. Nine of the 22 recipients with DSA (9/22, 40%) developed antibody-mediated rejection (AMR), while none of the 12 recipients with NDSA (0/12, 0%) developed AMR (P < 0.01). In a quantitative analysis of the MESF data, patients with DSA with MESF values of over 3000 frequently showed AMR (8/11, 73%). In contrast, one of the patients with DSA with MESF values of < 3000 showed AMR (1/11, 9%). One of the 12 patients (1/12, 8%) with NDSA showed cellular rejection (T-cell-mediated rejection), regardless of the MESF values. In patients with DSA, an MESF value of 3000 may be a useful cutoff value for identifying patients at a high risk for AMR.
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