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

17 Scopus citations

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)
Pages (from-to)E261-E268
JournalClinical Transplantation
Volume26
Issue number3
DOIs
StatePublished - May 1 2012

Keywords

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

ASJC Scopus subject areas

  • Transplantation

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    Nair, V., Sawinski, D., Akalin, E., Friedlander, R., Ebcioglu, Z., Sehgal, V., Dinavahi, R., Khaim, R., Ames, S., Lerner, S., Murphy, B., Bromberg, J. S., Heeger, P. S., & Schröppel, B. (2012). Effect of high-dose intravenous immunoglobulin on anti-HLA antibodies in sensitized kidney transplant candidates. Clinical Transplantation, 26(3), E261-E268. https://doi.org/10.1111/j.1399-0012.2012.01657.x