Hyperacute renal allograft rejection from anti-HLA class 1 antibody to B cells--antibody detection by two color FCXM was possible only after using pronase-digested donor lymphocytes.
Transpl Int
; 10(1): 69-73, 1997.
Article
in En
| MEDLINE
| ID: mdl-9002156
We present a report of a transplant recipient who lost her renal allograft from hyperacute rejection. This was secondary to a weak IgG anti-HLA class I antibody that was only reactive to donor B lymphocytes. This antibody was not detected in her pretransplant serum by the conventional complement-dependent cytotoxicity assays using donor blood lymphocytes. Pretransplant sera were analyzed retrospectively by two-color flow cytometric crossmatching (FCXM). It was difficult to determine if the recipient's serum contained an IgG antibody specific for HLA on donor B cells since IgG from control AB sera and pretransplant sera bound equally well to CD19 B cells. However, when donor lymphocytes were pretreated with pronase to digest the membrane receptor for Fc domain of IgG (Fc gamma R) on non-T-cells, control IgG in AB serum did not bind to B cells and, hence, it was easy to detect binding of IgG (in pretransplant sera) to HLA on B cells. This case underscores the importance of identifying weak anti-HLA class I antibodies reactive only to B cells. Moreover, it shows that the currently used two-color FCXM lacks the specificity to detect such antibodies.
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Collection:
01-internacional
Database:
MEDLINE
Main subject:
Immunoglobulin G
/
B-Lymphocytes
/
Histocompatibility Antigens Class I
/
Kidney Transplantation
/
Graft Rejection
/
Antibodies
Type of study:
Diagnostic_studies
/
Prognostic_studies
Limits:
Adult
/
Female
/
Humans
Language:
En
Journal:
Transpl Int
Year:
1997
Document type:
Article