Effect of high-dose intravenous immunoglobulin on anti-HLA antibodies in sensitized kidney transplant candidates

Vinay Nair, Deirdre Sawinski, Enver Akalin, Rex Friedlander, Zeynep Ebcioglu, Vinita Sehgal, Rajani Dinavahi, Rafael Khaim, Scott Ames, Susan Lerner, Barbara Murphy, Jonathan S. Bromberg, Peter S. Heeger, Bernd Schröppel

Research output: Contribution to journalArticle

16 Citations (Scopus)

Abstract

Limited data exist on the effect of intravenous immunoglobulin (IVIg) on anti-HLA antibodies as determined by solid-phase assays. We reviewed our experience treating sensitized wait-listed kidney transplant recipients with IVIg as a method for desensitization and report our results utilizing Luminex single antigen (LSA) bead assay to quantify antibody reactivity (MFI). Fifteen patients with a cPRA > 40% received 2 g/kg IVIg per month for four months or until transplanted. LSA testing was performed before and after IVIg. Median MFI for anti-class I antibodies fell in 11 (73%) and increased in 4 (27%) patients after IVIg. Similar significant changes in MFI for anti-class II antibodies were observed in 10 patients (66%). Administration of IVIg was associated with a modest decrease in reactivity to both class I and II HLA antigens (median MFI change 493 and 1110, respectively; p < 0.0001) but did not significantly alter mean cPRA (85% before IVIg vs. 80% after IVIg; p = 0.1). Our data suggest a smaller effect of IVIg on HLA antibody reactivity than previously described, leading us to question how best to measure the efficacy of a desensitization protocol in current practice.

Original languageEnglish (US)
JournalClinical Transplantation
Volume26
Issue number3
DOIs
StatePublished - May 2012

Fingerprint

Intravenous Immunoglobulins
Anti-Idiotypic Antibodies
Transplants
Kidney
Immunoglobulin Isotypes
Antigens
Antibodies
Histocompatibility Antigens Class II
HLA Antigens

Keywords

  • Desensitization
  • Intravenous immunoglobulin
  • Kidney transplantation
  • Panel reactive antibody
  • Sensitization

ASJC Scopus subject areas

  • Transplantation

Cite this

Effect of high-dose intravenous immunoglobulin on anti-HLA antibodies in sensitized kidney transplant candidates. / Nair, Vinay; Sawinski, Deirdre; Akalin, Enver; Friedlander, Rex; Ebcioglu, Zeynep; Sehgal, Vinita; Dinavahi, Rajani; Khaim, Rafael; Ames, Scott; Lerner, Susan; Murphy, Barbara; Bromberg, Jonathan S.; Heeger, Peter S.; Schröppel, Bernd.

In: Clinical Transplantation, Vol. 26, No. 3, 05.2012.

Research output: Contribution to journalArticle

Nair, V, Sawinski, D, Akalin, E, Friedlander, R, Ebcioglu, Z, Sehgal, V, Dinavahi, R, Khaim, R, Ames, S, Lerner, S, Murphy, B, Bromberg, JS, Heeger, PS & Schröppel, B 2012, 'Effect of high-dose intravenous immunoglobulin on anti-HLA antibodies in sensitized kidney transplant candidates', Clinical Transplantation, vol. 26, no. 3. https://doi.org/10.1111/j.1399-0012.2012.01657.x
Nair, Vinay ; Sawinski, Deirdre ; Akalin, Enver ; Friedlander, Rex ; Ebcioglu, Zeynep ; Sehgal, Vinita ; Dinavahi, Rajani ; Khaim, Rafael ; Ames, Scott ; Lerner, Susan ; Murphy, Barbara ; Bromberg, Jonathan S. ; Heeger, Peter S. ; Schröppel, Bernd. / Effect of high-dose intravenous immunoglobulin on anti-HLA antibodies in sensitized kidney transplant candidates. In: Clinical Transplantation. 2012 ; Vol. 26, No. 3.
@article{2e3bdeaacdfa405aa1bfe4428aca5b5d,
title = "Effect of high-dose intravenous immunoglobulin on anti-HLA antibodies in sensitized kidney transplant candidates",
abstract = "Limited data exist on the effect of intravenous immunoglobulin (IVIg) on anti-HLA antibodies as determined by solid-phase assays. We reviewed our experience treating sensitized wait-listed kidney transplant recipients with IVIg as a method for desensitization and report our results utilizing Luminex single antigen (LSA) bead assay to quantify antibody reactivity (MFI). Fifteen patients with a cPRA > 40{\%} received 2 g/kg IVIg per month for four months or until transplanted. LSA testing was performed before and after IVIg. Median MFI for anti-class I antibodies fell in 11 (73{\%}) and increased in 4 (27{\%}) patients after IVIg. Similar significant changes in MFI for anti-class II antibodies were observed in 10 patients (66{\%}). Administration of IVIg was associated with a modest decrease in reactivity to both class I and II HLA antigens (median MFI change 493 and 1110, respectively; p < 0.0001) but did not significantly alter mean cPRA (85{\%} before IVIg vs. 80{\%} after IVIg; p = 0.1). Our data suggest a smaller effect of IVIg on HLA antibody reactivity than previously described, leading us to question how best to measure the efficacy of a desensitization protocol in current practice.",
keywords = "Desensitization, Intravenous immunoglobulin, Kidney transplantation, Panel reactive antibody, Sensitization",
author = "Vinay Nair and Deirdre Sawinski and Enver Akalin and Rex Friedlander and Zeynep Ebcioglu and Vinita Sehgal and Rajani Dinavahi and Rafael Khaim and Scott Ames and Susan Lerner and Barbara Murphy and Bromberg, {Jonathan S.} and Heeger, {Peter S.} and Bernd Schr{\"o}ppel",
year = "2012",
month = "5",
doi = "10.1111/j.1399-0012.2012.01657.x",
language = "English (US)",
volume = "26",
journal = "Clinical Transplantation",
issn = "0902-0063",
publisher = "Wiley-Blackwell",
number = "3",

}

TY - JOUR

T1 - Effect of high-dose intravenous immunoglobulin on anti-HLA antibodies in sensitized kidney transplant candidates

AU - Nair, Vinay

AU - Sawinski, Deirdre

AU - Akalin, Enver

AU - Friedlander, Rex

AU - Ebcioglu, Zeynep

AU - Sehgal, Vinita

AU - Dinavahi, Rajani

AU - Khaim, Rafael

AU - Ames, Scott

AU - Lerner, Susan

AU - Murphy, Barbara

AU - Bromberg, Jonathan S.

AU - Heeger, Peter S.

AU - Schröppel, Bernd

PY - 2012/5

Y1 - 2012/5

N2 - Limited data exist on the effect of intravenous immunoglobulin (IVIg) on anti-HLA antibodies as determined by solid-phase assays. We reviewed our experience treating sensitized wait-listed kidney transplant recipients with IVIg as a method for desensitization and report our results utilizing Luminex single antigen (LSA) bead assay to quantify antibody reactivity (MFI). Fifteen patients with a cPRA > 40% received 2 g/kg IVIg per month for four months or until transplanted. LSA testing was performed before and after IVIg. Median MFI for anti-class I antibodies fell in 11 (73%) and increased in 4 (27%) patients after IVIg. Similar significant changes in MFI for anti-class II antibodies were observed in 10 patients (66%). Administration of IVIg was associated with a modest decrease in reactivity to both class I and II HLA antigens (median MFI change 493 and 1110, respectively; p < 0.0001) but did not significantly alter mean cPRA (85% before IVIg vs. 80% after IVIg; p = 0.1). Our data suggest a smaller effect of IVIg on HLA antibody reactivity than previously described, leading us to question how best to measure the efficacy of a desensitization protocol in current practice.

AB - Limited data exist on the effect of intravenous immunoglobulin (IVIg) on anti-HLA antibodies as determined by solid-phase assays. We reviewed our experience treating sensitized wait-listed kidney transplant recipients with IVIg as a method for desensitization and report our results utilizing Luminex single antigen (LSA) bead assay to quantify antibody reactivity (MFI). Fifteen patients with a cPRA > 40% received 2 g/kg IVIg per month for four months or until transplanted. LSA testing was performed before and after IVIg. Median MFI for anti-class I antibodies fell in 11 (73%) and increased in 4 (27%) patients after IVIg. Similar significant changes in MFI for anti-class II antibodies were observed in 10 patients (66%). Administration of IVIg was associated with a modest decrease in reactivity to both class I and II HLA antigens (median MFI change 493 and 1110, respectively; p < 0.0001) but did not significantly alter mean cPRA (85% before IVIg vs. 80% after IVIg; p = 0.1). Our data suggest a smaller effect of IVIg on HLA antibody reactivity than previously described, leading us to question how best to measure the efficacy of a desensitization protocol in current practice.

KW - Desensitization

KW - Intravenous immunoglobulin

KW - Kidney transplantation

KW - Panel reactive antibody

KW - Sensitization

UR - http://www.scopus.com/inward/record.url?scp=84862258442&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=84862258442&partnerID=8YFLogxK

U2 - 10.1111/j.1399-0012.2012.01657.x

DO - 10.1111/j.1399-0012.2012.01657.x

M3 - Article

C2 - 22686949

AN - SCOPUS:84862258442

VL - 26

JO - Clinical Transplantation

JF - Clinical Transplantation

SN - 0902-0063

IS - 3

ER -