Living donor kidney transplantation after desensitization in cross-match positive high sensitized patients.

BACKGROUND: We aimed to evaluate the long-term results of the patients who had positive cross-match (XM) test results and underwent living donor renal transplantation after desensitization with different combinations of intravenous immunoglobulin (IVIG), plasmapheresis (PP), and rituximab. MATERIAL AND METHODS: Forty-nine patients who were positive for complement-dependent cytotoxicity (CDC), flow cytometric (FC), and Luminex-XM test were included in the study. Renal transplantation was performed in 16 patients who had XM (-) test after desensitization with different combinations of IVIG (n =15), PP (n =13), and rituximab (n =10). Anti-human leukocyte antigens (HLA) antibodies (anti-HLA Abs) were detected by the Luminex single antigen bead assay. Anti-thymocyte globulin was used for induction, and tacrolimus, mycophenolic acid, and prednisolone were used for maintenance therapy. Also, we evaluated the relationship between different donor-specific anti-HLA Abs and the parameters mentioned above. RESULTS: Antibody-mediated rejection (AMR) and acute T cell-mediated rejection rates were 18.8 % and 6.3 %, respectively. Graft survival rates at the first, third, and fifth years post-transplantation were 93.8 %, 85.2 %, and 85.2 %, respectively, and the patients' survival rates were found to be 100 %. Serum creatinine level and glomerular filtration rate were 1.5 ± 1.2 mg/dl and 69.9 ± 30.4 ml/min, respectively. The mean follow-up time was 39 ± 24 months. CONCLUSIONS: Our study showed that kidney transplantation could be performed by effective desensitization in XM test positive patients. It was also shown that donor-specific anti-HLA DQ Ab and non-HLA Ab determination might be useful in diagnosing patients with positive cross-test and/or diagnosis of AMR. HIPPOKRATIA 2020, 24(4): 182-190.

A Successful Renal Transplantation Case After Stem Cell Transplantation.

Renal transplantation is the most effective treatment method for end-stage renal disease (ESRD). However, new treatment modalities are being investigated, such as immunotoleration, to avoid the acute and chronic side effects of immunosuppressant drugs. We report a case in which a man had undergone allogenic stem cell transplantation from his brother 16 years ago due to chronic myeloid leukemia, and who then developed ESRD due to arterial hypertension and underwent renal transplantation (Rtx) from the same brother. The patient was followed up without immunosuppression due to full chimerism.

SV40 Immortalization of feline fibroblasts as targets for MHC-restricted cytotoxic T-cell assays.

CTL assays in outbred cats have been difficult to perform because of a lack of a good source of syngeneic target cell. Primary fibroblasts from cats are widely used as target cells for MHC-restricted cytotoxic T-cell (CTL) assays, but their limited life-spans of 8-10 culture passages can be problematic for longitudinal studies. To circumvent the life-span limitations of primary fibroblast cultures, we developed a procedure for immortalizing feline primary fibroblast cells by transfection with a molecular clone of simian virus 40 (SV40). Fibroblast cultures from skin biopsies of 28 cats were immortalized using this procedure and have been passaged for longer than 6 months without showing any phenotypic difference from the original primary cells. Non-SV40 transfected feline fibroblasts from a selection of animals in the same group survived for only 6-8 weeks before reaching senescence. The immortalized fibroblasts expressed SV40 T-antigen and Class I MHC protein, and were successfully used as target cells in 51Cr release CTL assays in feline immunodeficiency virus (FIV)-infected cats and in vitro stimulated allogeneic T-cell cultures.