Association of Emergence of HLA Antibody and Acute Rejection in Intestinal Transplant Recipients

A Possible Evidence of Acute Humoral Sensitization

T. Kato, K. Mizutani, P. Terasaki, C. Quintini, G. Selvaggi, John F. Thompson, P. Ruiz, A. Tzakis

Research output: Contribution to journalArticle

29 Citations (Scopus)

Abstract

Development of HLA antibody has been associated with chronic allograft failure in kidney recipients. We tested HLA antibody in posttransplant sera of intestinal recipients: 126 sera from 28 pediatric recipients were tested for HLA antibody by flow PRA (f-PRA). Median age was 1.1 years (0.44-17). Graft types included isolated intestine (n = 6), liver and intestine (n = 3), modified multivisceral (n = 3), and multivisceral grafts (n = 16). Greater than 10% of either class I (CI) or class II (CII) f-PRA was considered positive, and >30% strongly positive. Five of 28 patients had positive f-PRA in multiple samples; the remaining 23 had either no positive or only one positive sample. Three patients had strongly positive f-PRA. Patients with multiple positive samples were recipients of two modified multivisceral and three multivisceral grafts. Only one of these patients had a positive PRA pretransplant. Cytotoxic cross-match at transplant was negative for all. The three with strongly positive f-PRA showed significant episodes of rejection around the time of positive samples. One of them who persistently had f-PRA value >80% (from day 13-113) died of refractory rejection. The other two had f-PRA of 76% and 53% during the early postoperative course with associated episodes of rejection. F-PRA value decreased with rejection therapy. Only one of the 23 patients (4%) with negative f-PRA had an episode of rejection around the time of sample collection. Development of HLA antibody after intestinal transplantation seems to have significant association with acute rejection episodes.

Original languageEnglish (US)
Pages (from-to)1735-1737
Number of pages3
JournalTransplantation Proceedings
Volume38
Issue number6
DOIs
StatePublished - Jul 2006
Externally publishedYes

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Antibodies
Transplants
Intestines
Serum
Renal Insufficiency
Allografts
Transplantation
Transplant Recipients
Pediatrics
Liver
Therapeutics

ASJC Scopus subject areas

  • Surgery
  • Transplantation

Cite this

Association of Emergence of HLA Antibody and Acute Rejection in Intestinal Transplant Recipients : A Possible Evidence of Acute Humoral Sensitization. / Kato, T.; Mizutani, K.; Terasaki, P.; Quintini, C.; Selvaggi, G.; Thompson, John F.; Ruiz, P.; Tzakis, A.

In: Transplantation Proceedings, Vol. 38, No. 6, 07.2006, p. 1735-1737.

Research output: Contribution to journalArticle

Kato, T. ; Mizutani, K. ; Terasaki, P. ; Quintini, C. ; Selvaggi, G. ; Thompson, John F. ; Ruiz, P. ; Tzakis, A. / Association of Emergence of HLA Antibody and Acute Rejection in Intestinal Transplant Recipients : A Possible Evidence of Acute Humoral Sensitization. In: Transplantation Proceedings. 2006 ; Vol. 38, No. 6. pp. 1735-1737.
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abstract = "Development of HLA antibody has been associated with chronic allograft failure in kidney recipients. We tested HLA antibody in posttransplant sera of intestinal recipients: 126 sera from 28 pediatric recipients were tested for HLA antibody by flow PRA (f-PRA). Median age was 1.1 years (0.44-17). Graft types included isolated intestine (n = 6), liver and intestine (n = 3), modified multivisceral (n = 3), and multivisceral grafts (n = 16). Greater than 10{\%} of either class I (CI) or class II (CII) f-PRA was considered positive, and >30{\%} strongly positive. Five of 28 patients had positive f-PRA in multiple samples; the remaining 23 had either no positive or only one positive sample. Three patients had strongly positive f-PRA. Patients with multiple positive samples were recipients of two modified multivisceral and three multivisceral grafts. Only one of these patients had a positive PRA pretransplant. Cytotoxic cross-match at transplant was negative for all. The three with strongly positive f-PRA showed significant episodes of rejection around the time of positive samples. One of them who persistently had f-PRA value >80{\%} (from day 13-113) died of refractory rejection. The other two had f-PRA of 76{\%} and 53{\%} during the early postoperative course with associated episodes of rejection. F-PRA value decreased with rejection therapy. Only one of the 23 patients (4{\%}) with negative f-PRA had an episode of rejection around the time of sample collection. Development of HLA antibody after intestinal transplantation seems to have significant association with acute rejection episodes.",
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