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A noninvasive diagnostic approach to retrospective donor HLA typing in kidney transplant patients using urine.
Bach, Christian; Knaup, Karl X; Herrmann, Markus; Krumbiegel, Mandy; Pfister, Frederick; Büttner-Herold, Maike; Steffen, Martin; Zecher, Daniel; Lopau, Kai; Schneider, Karen; Dieterle, Anne; Amann, Kerstin; Reis, André; Schiffer, Mario; Spriewald, Bernd M; Wiesener, Michael S.
Affiliation
  • Bach C; Department of Internal Medicine 5 - Haematology and Oncology, Friedrich-Alexander-University Erlangen-Nürnberg (FAU), University Hospital Erlangen, Erlangen, Germany.
  • Knaup KX; Department of Internal Medicine 4 - Nephrology and Hypertension, Friedrich-Alexander-University Erlangen-Nürnberg (FAU), University Hospital Erlangen, Erlangen, Germany.
  • Herrmann M; Department of Internal Medicine 4 - Nephrology and Hypertension, Friedrich-Alexander-University Erlangen-Nürnberg (FAU), University Hospital Erlangen, Erlangen, Germany.
  • Krumbiegel M; Institute of Human Genetics, Friedrich-Alexander-University Erlangen-Nürnberg (FAU), University Hospital Erlangen, Erlangen, Germany.
  • Pfister F; Department of Nephropathology, Institute of Pathology, Friedrich-Alexander-University Erlangen-Nürnberg (FAU), University Hospital Erlangen, Erlangen, Germany.
  • Büttner-Herold M; Department of Nephropathology, Institute of Pathology, Friedrich-Alexander-University Erlangen-Nürnberg (FAU), University Hospital Erlangen, Erlangen, Germany.
  • Steffen M; Department of Internal Medicine 3 - Rheumatology and Immunology, Friedrich-Alexander-University Erlangen-Nürnberg (FAU), University Hospital Erlangen, Erlangen, Germany.
  • Zecher D; Department of Nephrology, University Hospital Regensburg, Regensburg, Germany.
  • Lopau K; Department of Internal Medicine, University of Würzburg, Würzburg, Germany.
  • Schneider K; Department of Internal Medicine 4 - Nephrology and Hypertension, Friedrich-Alexander-University Erlangen-Nürnberg (FAU), University Hospital Erlangen, Erlangen, Germany.
  • Dieterle A; Department of Internal Medicine 4 - Nephrology and Hypertension, Friedrich-Alexander-University Erlangen-Nürnberg (FAU), University Hospital Erlangen, Erlangen, Germany.
  • Amann K; Department of Nephropathology, Institute of Pathology, Friedrich-Alexander-University Erlangen-Nürnberg (FAU), University Hospital Erlangen, Erlangen, Germany.
  • Reis A; Institute of Human Genetics, Friedrich-Alexander-University Erlangen-Nürnberg (FAU), University Hospital Erlangen, Erlangen, Germany.
  • Schiffer M; Department of Internal Medicine 4 - Nephrology and Hypertension, Friedrich-Alexander-University Erlangen-Nürnberg (FAU), University Hospital Erlangen, Erlangen, Germany.
  • Spriewald BM; Department of Internal Medicine 5 - Haematology and Oncology, Friedrich-Alexander-University Erlangen-Nürnberg (FAU), University Hospital Erlangen, Erlangen, Germany.
  • Wiesener MS; Department of Internal Medicine 4 - Nephrology and Hypertension, Friedrich-Alexander-University Erlangen-Nürnberg (FAU), University Hospital Erlangen, Erlangen, Germany.
Transpl Int ; 34(7): 1226-1238, 2021 07.
Article in En | MEDLINE | ID: mdl-33904183
Antibody-mediated rejection (AMR) is a major obstacle to long-term kidney transplantation. AMR is mostly caused by donor specific HLA antibodies, which can arise before or any time after transplantation. Incomplete donor HLA typing and unavailability of donor DNA regularly preclude the assessment of donor-specificity of circulating anti-HLA antibodies. In our centre, this problem arises in approximately 20% of all post-transplant HLA-antibody assessments. We demonstrate that this diagnostic challenge can be resolved by establishing donor renal tubular cell cultures from recipient´s urine as a source of high-quality donor DNA. DNA was then verified for genetic origin and purity by fluorescence in situ hybridization and short tandem repeat analysis. Two representative cases highlight the diagnostic value of this approach which is corroborated by analysis of ten additional patients. The latter were randomly sampled from routine clinical care patients with available donor DNA as controls. In all 12 cases, we were able to perform full HLA typing of the respective donors confirmed by cross-comparison to results from the stored 10 donor DNAs. We propose that this noninvasive diagnostic approach for HLA typing in kidney transplant patients is valuable to determine donor specificity of HLA antibodies, which is important in clinical assessment of suspected AMR.
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Full text: 1 Collection: 01-internacional Database: MEDLINE Main subject: Kidney Transplantation Type of study: Diagnostic_studies / Observational_studies Limits: Humans Language: En Journal: Transpl Int Journal subject: TRANSPLANTE Year: 2021 Document type: Article Affiliation country: Germany Country of publication: Switzerland

Full text: 1 Collection: 01-internacional Database: MEDLINE Main subject: Kidney Transplantation Type of study: Diagnostic_studies / Observational_studies Limits: Humans Language: En Journal: Transpl Int Journal subject: TRANSPLANTE Year: 2021 Document type: Article Affiliation country: Germany Country of publication: Switzerland