Antibodies in alloimmunized uraemic patients treated with recombinant erythropoietin.
We have retrospectively analysed sera from 52 already sensitized uraemic patients collected over 1 year and compared erythropoietin (EPO)-treated with non-EPO-treated patients. Significantly fewer (P<0.01) patients (33%) on dialysis because of the rejection of their kidney grafts received EPO than patients on dialysis because of underlying kidney disease (71%). EPO treatment reduced the number of additional blood transfusions, since 3/28 EPO-treated but 12/24 non-EPO-treated patients were given blood (P<0.05). Among the EPO-treated patients, 64% showed a loss of panel-reactive antibodies (PRA), as measured by the micro-lymphocytotoxic technique, while only 12.5% of the non-treated patients showed a loss of PRA (P<0.01). In the subgroup of transplanted patients, PRA loss was only found among the EPO-treated patients, but their number was small (P<0.05). The class, subclass and specificities of the antibodies, as determined by FACS (flow cytometry) analyses, showed no distinct differences between EPO- and non-EPO-treated patients. The differences were significant between transfused and previously transplanted patients.
Department of Renal Medicine, Karolinska Institute, Huddinge University Hospital, Sweden.
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Fehrman-Ekholm
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Sumitran-Karuppan
D000740:Anemia / Q000517:prevention & control; D000906:Antibodies / Q000097:blood*; D004921:Erythropoietin / Q000627:therapeutic use*; D006801:Humans; D007070:Immunoglobulin A / Q000097:blood; D007075:Immunoglobulin M / Q000097:blood; D007676:Kidney Failure, Chronic / Q000150:complications / Q000188:drug therapy* / Q000276:immunology*; D016030:Kidney Transplantation / Q000276:immunology; D010531:Peritoneal Dialysis, Continuous Ambulatory; D011994:Recombinant Proteins; D006435:Renal Dialysis; D012189:Retrospective Studies; D013602:T-Lymphocytes, Cytotoxic / Q000276:immunology; D014511:Uremia / Q000150:complications / Q000188:drug therapy* / Q000276:immunology
D000906:Antibodies; D007070:Immunoglobulin A; D007075:Immunoglobulin M; D011994:Recombinant Proteins; D004921:Erythropoietin