Positive pre-transplant flow-panel reactive antibody detected after accelerated acute rejection with negative pre-transplant flow crossmatch

被引：4

作者：

Miura, Masayoshi

Kubota, Kanako C.

Itoh, Tomoo

Ono, Takenori

Morita, Ken

Watarai, Yoshihiko

Harada, Hiroshi

Hirano, Tetsuo

Nonomura, Katsuya

机构：

[1] Hokkaido Univ, Grad Sch Med, Dept Renal & Genitourinary Surg, Kita Ku, Sapporo, Hokkaido 0608648, Japan

[2] Hokkaido Univ Hosp, Dept Surg Pathol, Sapporo, Hokkaido 060, Japan

[3] Sapporo City Gen Hosp, Dept Renal Transplantat, Sapporo, Hokkaido, Japan

来源：

CLINICAL TRANSPLANTATION | 2006年 / 20卷

关键词：

antibody-mediated rejection; donor specific antibody; flow panel reactive antibody; renal transplantation;

D O I：

10.1111/j.1399-0012.2006.00547.x

中图分类号：

R61 [外科手术学];

学科分类号：

摘要：

A 30-yr-old woman underwent kidney transplantation from a flow cytometric lymphocyte crossmatch-negative donor. Immunosuppression consisted of tacrolimus, mycophenolate mofetil, basiliximab and three days of steroid. On day 5 post-transplant, she developed acute rejection and underwent anti-rejection therapy consisting of steroid pulse and deoxyspurgualin. Retrospective analyses of anti-human leukocyte antigen antibody revealed high flow panel reactive antibody (PRA) in the pre-transplant serum without donor specific antibody (DSA) and positive DSA at the time of rejection. Anti-rejection therapy was successful in treating cellular rejection but her graft function further deteriorated after three months post-transplant and graft biopsy revealed chronic allograft nephropathy with positive staining for C4d in peritubular capillary, suggesting the presence of chronic antibody-mediated rejection. Pre-transplant positive flow PRA without DSA may also be a risk for acute and chronic rejection.

引用

页码：33 / 37

页数：5

共 4 条

[1]

Cho Y W, 2001, Clin Transpl, P237

[2]

Gloor J, 2005, CONTRIB NEPHROL, V146, P11, DOI 10.1159/000082057

[3] Evaluation of flow cytometric panel reactive antibody in renal transplant recipients - examination of 238 cases of renal transplantation [J].

Ishida, H ;

Tanabe, K ;

Furusawa, M ;

Ishizuka, T ;

Hayash, T ;

Tokumoto, T ;

Miyamoto, N ;

Shirakawa, H ;

Shimmura, H ;

Shimizu, T ;

Toma, H .

TRANSPLANT INTERNATIONAL, 2005, 18 (02) :163-168

[4] The Banff 97 working classification of renal allograft pathology [J].

Racusen, LC ;

Solez, K ;

Colvin, RB ;

Bonsib, SM ;

Castro, MC ;

Cavallo, T ;

Croker, BP ;

Demetris, AJ ;

Drachenberg, CB ;

Fogo, AB ;

Furness, P ;

Gaber, LW ;

Gibson, IW ;

Glotz, D ;

Goldberg, JC ;

Grande, J ;

Halloran, PF ;

Hansen, HE ;

Hartley, B ;

Hayry, PJ ;

Hill, CM ;

Hoffman, EO ;

Hunsicker, LG ;

Lindblad, AS ;

Marcussen, N ;

Mihatsch, MJ ;

Nadasdy, T ;

Nickerson, P ;

Olsen, TS ;

Papadimitriou, JC ;

Randhawa, PS ;

Rayner, DC ;

Roberts, I ;

Rose, S ;

Rush, D ;

Salinas-Madrigal, L ;

Salomon, DR ;

Sund, S ;

Taskinen, E ;

Trpkov, K ;

Yamaguchi, Y .

KIDNEY INTERNATIONAL, 1999, 55 (02) :713-723

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