Effect of anti-HLA and anti-idiotypic antibodies on the long-term survival of heart and kidney allografts.
Long-term survival of heart and kidney allografts is threatened by the development of chronic rejection. Analysis of the relationship between reversible acute rejection episodes and actuarial survival at 5 years showed an inverse correlation suggesting that early cellular events may trigger antibody-mediated chronic rejection. In both heart and kidney allograft recipients producing anti-HLA antibodies we found a significant decrease in the 5-year graft survival rate. However, there was heterogeneity among anti-HLA antibody producers with respect to the development of anti-idiotypic antibodies. The actuarial 5-year graft survival was significantly higher in patients with Ab2 compared to patients without.
Reed
E
E
Department of Pathology, College of Physicians and Surgeons, Columbia University, New York, NY 10032.
Cohen
D J
DJ
Barr
M L
ML
Ho
E
E
Marboe
C C
CC
Rose
E A
EA
Hardy
M
M
Suciu-Foca
N
N
D000206:Actuarial Analysis; D000888:Antibodies, Anti-Idiotypic / Q000032:analysis*; D002908:Chronic Disease; D016572:Cyclosporine / Q000008:administration & dosage; D005500:Follow-Up Studies; D006084:Graft Rejection / Q000276:immunology* / Q000401:mortality; D006085:Graft Survival / Q000276:immunology*; D006680:HLA Antigens / Q000276:immunology*; D016027:Heart Transplantation / Q000276:immunology* / Q000401:mortality; D006650:Histocompatibility Testing; D006801:Humans; D007518:Isoantibodies / Q000032:analysis*; D016030:Kidney Transplantation / Q000276:immunology* / Q000401:mortality; D011183:Postoperative Complications / Q000276:immunology* / Q000401:mortality; D015996:Survival Rate
D000888:Antibodies, Anti-Idiotypic; D006680:HLA Antigens; D007518:Isoantibodies; D016572:Cyclosporine