Your browser doesn't support javascript.
loading
Mostrar: 20 | 50 | 100
Resultados 1 - 4 de 4
Filtrar
1.
Front Immunol ; 13: 1093359, 2022.
Artículo en Inglés | MEDLINE | ID: mdl-36703958

RESUMEN

Background: The impact of donor-specific antibodies (DSA) in (highly-) immunized living donor kidney transplant recipients is reported differentially in various patient cohorts. Methods: We have performed a retrospective analysis of all consecutive HLA-incompatible living donor kidney transplant recipients in our center between 2010-2019. Recipients who underwent plasmafiltration for a positive CDC-crossmatch were excluded. For each DSA+ recipient (DSA+), one immunized recipient without DSA (pPRA+) and two non-immunized recipients (pPRA-) were included. Patient and graft survival were analyzed and a subgroup analysis of DSA+ recipients was performed. Results: For 63 DSA+ recipients, 63 PRA+ and 126 PRA- recipients were included. 26 (41%) had class I, 24 (38%) class II and 13 (21%) combined HLA class I and II DSA. Death-censored graft survival was inferior in DSA+ recipients compared to pPRA+ (HR 2.38 [95% CI 1.00-5.70]) as well as to pPRA- (HR 3.91 [1.86-8.22]). In multivariate analysis, DSA remained of negative influence on death-censored graft survival. Flowcytometric crossmatch, MFI value, HLA class and origin of DSA were not of significant impact. Conclusion: In our cohort of (highly-) immunized recipients, pretransplant DSA led to inferior death-censored graft survival. There were no "safe" DSA characteristics since only DSA per se impacted death-censored graft survival.


Asunto(s)
Trasplante de Riñón , Donadores Vivos , Humanos , Estudios Retrospectivos , Trasplante de Riñón/efectos adversos , Antígenos HLA , Anticuerpos
2.
J Reprod Immunol ; 137: 103074, 2020 02.
Artículo en Inglés | MEDLINE | ID: mdl-31864034

RESUMEN

In oocyte donation (OD) pregnancy, a fetus can be completely allogeneic to the recipient. Consequently, the maternal immune system has to cope with greater immunogenetic dissimilarity compared to naturally conceived pregnancy. Previously, we showed an association between successful OD pregnancy and lower immunogenetic dissimilarity, reflected by the number of fetal-maternal Human Leukocyte Antigen (HLA) mismatches, than expected by chance. In this study we aimed to determine whether the development of preeclampsia in OD pregnancies is related to the number of fetal-maternal HLA mismatches. A retrospective, nested case-control study was performed within a cohort of 76 singleton OD pregnancies. Maternal and fetal umbilical cord blood was typed for HLA-A, -B, -C, -DR and -DQ, and the number of fetal-maternal HLA mismatches was calculated. In addition, the incidence of child-specific HLA antibodies was determined. 13 pregnancies were complicated by preeclampsia. To demonstrate an influence of HLA mismatches on the development of preeclampsia, a univariate logistic regression analysis was performed adjusted for maternal age and socio-economic status. A significant association between the number of fetal-maternal HLA class II mismatches and the development of preeclampsia was observed (OR = 3.8, 95 % CI: 1.6-9.0; p = 0.003). This association was not linked to the development of HLA class II antibodies. According to our findings, an increased number of HLA class II mismatches is a risk factor for the development of preeclampsia in OD pregnancies. The effect of HLA class II mismatches might be explained by the induction of a cellular rather than a humoral immune response.


Asunto(s)
Fertilización In Vitro/efectos adversos , Antígenos HLA-DQ/inmunología , Antígenos HLA-DR/inmunología , Donación de Oocito/efectos adversos , Preeclampsia/inmunología , Adulto , Estudios de Casos y Controles , Femenino , Sangre Fetal/inmunología , Feto/inmunología , Humanos , Tolerancia Inmunológica , Inmunidad Celular , Inmunoglobulina G/sangre , Inmunoglobulina G/inmunología , Inmunofenotipificación , Incidencia , Isoanticuerpos/sangre , Isoanticuerpos/inmunología , Intercambio Materno-Fetal/inmunología , Persona de Mediana Edad , Preeclampsia/sangre , Preeclampsia/diagnóstico , Preeclampsia/epidemiología , Embarazo , Estudios Retrospectivos , Factores de Riesgo
3.
Am J Transplant ; 14(4): 936-42, 2014 Apr.
Artículo en Inglés | MEDLINE | ID: mdl-24712331

RESUMEN

Early pancreas graft loss is usually attributed to technical failure while the possibility of antibody-mediated rejection (AMR) is generally overlooked. To investigate the role of AMR in early pancreas graft loss, we retrospectively assessed 256 patients with simultaneous pancreas-kidney transplantation (SPK) between 1985 and 2010 at our institute. We included 33 SPK patients who lost their pancreas graft <1 year after transplantation. AMR was diagnosed based on donor-specific antibodies, C4d and histology in 7 cases, 8 cases were suspicious for AMR and 18 pancreas graft losses were not due to AMR. Acute AMR occurred >1 month after transplantation in 6/7 cases, whereas all other causes typically led to loss <1 month after transplantation. Thrombotic lesions occurred equally among the 33 cases. In 12/18 concurrent kidney specimens, the diagnostic results paralleled those of the pancreas graft. All patients with acute AMR of the pancreas graft lost their renal grafts <1 year after transplantation. In the setting of a thrombotic event, histopathological analysis of early pancreas graft loss is advisable to rule out the possibility of AMR, particularly because a diagnosis of acute AMR has important consequences for renal graft outcomes.


Asunto(s)
Rechazo de Injerto/diagnóstico , Isoanticuerpos/sangre , Trasplante de Riñón/efectos adversos , Trasplante de Páncreas/efectos adversos , Enfermedades Pancreáticas/complicaciones , Complicaciones Posoperatorias/diagnóstico , Trombosis/fisiopatología , Adulto , Aloinjertos , Estudios de Casos y Controles , Complemento C4b/inmunología , Femenino , Estudios de Seguimiento , Rechazo de Injerto/etiología , Rechazo de Injerto/mortalidad , Humanos , Inmunidad Celular/inmunología , Isoanticuerpos/inmunología , Masculino , Persona de Mediana Edad , Enfermedades Pancreáticas/cirugía , Fragmentos de Péptidos/inmunología , Complicaciones Posoperatorias/etiología , Complicaciones Posoperatorias/mortalidad , Pronóstico , Estudios Retrospectivos , Factores de Riesgo , Tasa de Supervivencia , Donantes de Tejidos
4.
Tissue Antigens ; 77(3): 225-8, 2011 Mar.
Artículo en Inglés | MEDLINE | ID: mdl-21299527

RESUMEN

The purpose of the study was to compare three different methods defining donor-specific antibodies (DSA): complement-dependent cytotoxicity (CDC), the flow cytometry method (FCM), and a special for that purpose commercially available Luminex-based solid phase assay (SPA). A panel of human monoclonal antibodies (HuMabs) with well-defined human leukocyte antigen (HLA) specificities was used as antibody source and single HLA antigen expressing cell lines (SAL) were used as targets. Two methods yielded identical results (CDC and FCM). However, the SPA, the method by which solubilized HLA molecules from the SAL are captured by microspheres, showed two additional reactions which could not be explained, neither by the epitope recognized by the HuMab nor by the widely accepted sensitivity of the SPA methodology. These unexplained results suggest that by capturing solubilized HLA molecules on microspheres, conformational changes might occur. Positive results obtained by similar Luminex-based microsphere methods should be therefore taken with caution and the 'recognized' HLA antigens should not automatically be considered as unacceptable for transplantation.


Asunto(s)
Anticuerpos/sangre , Anticuerpos/aislamiento & purificación , Donantes de Sangre , Extracción en Fase Sólida/estadística & datos numéricos , Extracción en Fase Sólida/normas , Anticuerpos/química , Anticuerpos Monoclonales/inmunología , Especificidad de Anticuerpos , Línea Celular , Pruebas Inmunológicas de Citotoxicidad/métodos , Pruebas Inmunológicas de Citotoxicidad/normas , Citometría de Flujo/métodos , Prueba de Histocompatibilidad/métodos , Prueba de Histocompatibilidad/normas , Humanos , Células K562 , Estándares de Referencia , Estudios Retrospectivos , Sensibilidad y Especificidad
SELECCIÓN DE REFERENCIAS
DETALLE DE LA BÚSQUEDA
...