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Journals / Türk Nefroloji Diyaliz ve Transplantasyon Dergisi / 2016 / Cilt: 25 - Sayı: 1

The Influence of Preformed Hla Class I and II Panel Reactive Antibodies on Clinical and Pathological Outcomes of Kidney Allograft

Pretransplant Gelişmiş Hla Sınıf I ve II Panel Reaktif Antikorların Böbrek Allogrefti Üzerine Klinik ve Patolojik Düzeyde Etkileri

Çağlar RUHİ
Başak BOYNUEĞRİ
Mesut İzzet TİTİZ
Pınar ATA
Süheyla APAYDIN
Umut KASAPOĞLU
Murat TUĞCU
Gülistan GÜMRÜKÇÜ
Pages
73–78
Publication Date
2022-11-06
DOI
—
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⚡ TL;DR(Too Long; Didn't Read)

These significant clinical and pathological outcomes were not observed for PRA Class-I and PRA Class I+II positive patients.CONCLUSION: Preformed anti-HLA Class-II antibodies are responsible for increased allograft rejection and reduced graft survival despite the negative flow cytometric lymphocyte crossmatch in kidney transplantation

📌 3 Key Takeaways

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Objective & Hypothesis:OBJECTIVE: The aim of the study was to investigate the influence of preformed anti-HLA antibodies that are represented by peak PRA levels on clinical and histopathologic outcomes of kidney allograft.
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Key Findings & Data:MATERIAL and METHODS: The study was a retrospective cohort that consisted of 111 kidney transplant recipients.
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Conclusion & Impact:These significant clinical and pathological outcomes were not observed for PRA Class-I and PRA Class I+II positive patients.CONCLUSION: Preformed anti-HLA Class-II antibodies are responsible for increased allograft rejection and reduced graft survival despite the negative flow cytometric lymphocyte crossmatch in kidney transplantation
🔬Design:Research Article
📍Scope:2011 Verileri
⚙️Variables:Domain Parameters

Abstract

OBJECTIVE: The aim of the study was to investigate the influence of preformed anti-HLA antibodies that are represented by peak PRA levels on clinical and histopathologic outcomes of kidney allograft. MATERIAL and METHODS: The study was a retrospective cohort that consisted of 111 kidney transplant recipients. A peak PRA level greater than 15% was accepted positive for HLA class I and II antibodies. Flow cytometric assay was used for PRA and lymphocyte cross-match (LCM). All recipients were LCM negative. Allograft biopsies were indication biopsy and evaluated according to Banff 2011 criteria to investigate the influence of HLA antibodies.RESULTS: PRA was positive in 21.5% of patients for Class-I and 22.5% for Class-II antibodies. PRA Class-II positive patients had significantly more graft failure (p=0.028), death censored graft failure (p=0.008), acute rejection (p=0.016) and chronic rejection (p=0.029). Regarding the pathological evaluation, peritubular capillaritis score was significantly higher in PRA Class-II positive patients (0.44±0.78 vs. 1.55±1.12, p=0.008) and more patients had a glomerulitis+peritubular capillaritis score >=2 (64% vs. 36%, p=0.026). These significant clinical and pathological outcomes were not observed for PRA Class-I and PRA Class I+II positive patients.CONCLUSION: Preformed anti-HLA Class-II antibodies are responsible for increased allograft rejection and reduced graft survival despite the negative flow cytometric lymphocyte crossmatch in kidney transplantation

Özet

AMAÇ: Böbrek nakli öncesi gelişmiş ve tepe-PRA düzeyleri kullanılarak değerlendirilen anti-HLA Sınıf-I ve II antikorlarının, klinik sonlanımlar ve histopatolojik düzeyde allogreft üzerine olan etkileri araştırıldı.GEREÇ ve YÖNTEMLER: Merkezimizde böbrek nakli olan 111 hastanın verileri geriye dönük olarak değerlendirildi. Tepe-PRA düzeyinin >%15 olması, HLA Sınıf-I ve/veya Sınıf-II antikorlar için pozitif kabul edildi. Lenfosit çapraz karşılaştırma (LÇK) ve PRA düzeyi ölçümlerinde akım sitometri yöntemi kullanıldı. Preoperatif bütün hastalarda LÇK negatifti. Histopatolojik olarak allogreft biyopsileri Banff 2011 kriterlerine göre HLA antikorların etkileri açısından değerlendirildi.BULGULAR: PRA Sınıf-I %21,5, PRA Sınıf-II ise %22,5 hastada pozitifti. PRA Sınıf-II pozitif hastalar, negatif olanlarla kıyaslandığında anlamlı olarak greft kaybı (p=0,028), ölüm-dışı greft kaybı (p=0,008), akut rejeksiyon (p=0,016) ve kronik rejeksiyon gelişimi (p=0,029) daha fazla bulundu. Histopatolojik olarak, PRA Sınıf-II pozitif olan hastalarda, negatif olanlara göre peritubular kapillerit skorunun daha yüksek (0,44±0,78'e karşı 1,55±1,12, p=0,008) ve glomerülit+peritubular kapillerit skorunun >=2 olan hastaların daha fazla olduğu bulundu (%64'e karşı %36, p=0,026). PRA Sınıf-I ve PRA Sınıf I+II pozitif olanlarda ise klinik veya histopatolojik düzeyde negatif olanlara göre anlamlı bir farklılık yoktu.SONUÇ: Böbrek nakli öncesi PRA yöntemi ile saptanmış HLA Sınıf-II antikoru olan hastalar, LÇK negatif olsa bile allogreft rejeksiyonu ve azalmış greft sağ kalımı riski taşırlar

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Cite This Article

RUHİ, Ç., BOYNUEĞRİ, B., TİTİZ, M. İ., ATA, P., APAYDIN, S., KASAPOĞLU, U., TUĞCU, M., GÜMRÜKÇÜ, G. (2022). The Influence of Preformed Hla Class I and II Panel Reactive Antibodies on Clinical and Pathological Outcomes of Kidney Allograft. Türk Nefroloji Diyaliz ve Transplantasyon Dergisi, Cilt: 25 - Sayı: 1, 73–78. https://ajindex.com/articles/636203

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References (13)

  1. Klein J, Sato A: The HLA system. First of two parts. N Engl J Med 2000;343:702-709
  2. Fuggle SV, Martin S: Tools for human leukocyte antigen antibody detection and their application to transplanting sensitized patients. Transplantation 2008;86:384-390
  3. Gebel HM, Bray RA, Nickerson P: Pre-Transplant Assessment of Donor-Reactive, HLA-Specific Antibodies in Renal Transplantation: Contraindication vs. risk. Am J Transplant 2003;3:1488-1500
  4. Terasaki PI, Ozawa M: Predicting kidney graft failure by HLA antibodies: A prospective trial. Am J Transplant 2004;4:438-443
  5. Süsal C, Döhler B, Opelz G: Presensitized kidney graft recipients with HLA class I and II antibodies are at increased risk for graft failure: A Collaborative Transplant Study report. Hum Immunol 2009;70:569-573
  6. Lim WH, Chapman JR, Wong G: Peak panel reactive antibody, cancer, graft, and patient outcomes in kidney transplant recipients. Transplantation 2015;99:1043-1050
  7. Valenzuela NM, Reed EF: Antibodies in transplantation: The effects of HLA and non-HLA antibody binding and mechanisms of injury. Methods Mol Biol 2013;1034:41-70
  8. Muczynski KA, Ekle DM, Coder DM, Anderson SK: Normal human kidney HLA-DR-expressing renal microvascular endothelial cells: Characterization, isolation, and regulation of MHC class II expression. J Am Soc Nephrol 2003;14:1336-1348
  9. Campos EF, Tedesco-Silva H, Machado PG, Franco M, Medina- Pestana JO, Gerbase-DeLima M: Post-transplant anti-HLA class II antibodies as risk factor for late kidney allograft failure. Am J Transplant 2006;6:2316-2320
  10. Issa N, Cosio FG, Gloor JM, Sethi S, Dean PG, Moore SB, DeGoey S, Stegall MD: Transplant glomerulopathy: Risk and prognosis related to anti-human leukocyte antigen class II antibody levels. Transplantation 2008;86:681-685
  11. Song EY, Lee YJ, Hyun J, Kim YS, Ahn C, Ha J, Kim SJ, Park MH: Clinical relevance of pretransplant HLA class II donor-specific antibodies in renal transplantation patients with negative T-cell cytotoxicity crossmatches. Ann Lab Med 2012;32:139-144
  12. Gebel HM, Harris SB, Zibari G, Bray RA: Conundrums with FlowPRA beads. Clin Transplant 2002;16:24-29 Lobashevsky AL: Methodological aspects of anti-human leukocyte antigen antibody analysis in solid organ transplantation. World J Transplant 2014;4:153-167
  13. Ishida H, Tanabe K, Furusawa M, Ishizuka T, Hayashi T, Tokumoto T, Miyamoto N, Shirakawa H, Shimmura H, Shimizu T, Toma H: Evaluation of flow cytometric panel reactive antibody in renal transplant recipients - examination of 238 case