Monitoring anti-HLA Class I IgG antibodies in renal transplant recipients.
Anti-HLA class I IgG antibodies play an important role in hyperacute rejection but the significance of its de novo appearance or increase in levels during the posttransplant period remains controversial. The purpose of this study was to determine the correlation between the anti-HLA class I IgG antibodies and posttransplant events during the first 4 months after renal transplantation. From 200 renal allograft recipients, 549 serum samples were retrospectively evaluated. Patients who experienced graft dysfunction confirmed by biopsy had three serum samples tested: before, during (within 24 hours), and after the event. The presence of anti-HLA antibodies was observed in recipients with chronic allograft nephropathy (60%); acute rejection (clinical criteria without biopsy 57.1%); rejection types IIA (7.1%), IIB (40%), and III (50%); borderline changes (42.8%); acute tubular necrosis (34.4%); infarction (25%); and no rejection (12.5%). We observed a high incidence of anti-HLA class I IgG antibodies during acute tubular necrosis, borderline changes, acute rejection types IIB and III, and chronic allograft nephropathy.
Aragão
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Nephrology Division, São Paulo Federal University, Kidney and Hypertension Hospital, Sao Paulo, SP, Brazil. beth@nefro.epm.br
Moura
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LA
Pacheco-Silva
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A
D000208:Acute Disease; D002908:Chronic Disease; D006084:Graft Rejection / Q000276:immunology; D015395:Histocompatibility Antigens Class I / Q000097:blood*; D006801:Humans; D007074:Immunoglobulin G / Q000097:blood*; D016030:Kidney Transplantation / Q000276:immunology*; D015166:Monitoring, Immunologic; D011183:Postoperative Complications / Q000276:immunology / Q000473:pathology
D015395:Histocompatibility Antigens Class I; D007074:Immunoglobulin G