Correlation between human leukocyte antigen antibody production and serum creatinine in patients receiving sirolimus monotherapy after Campath-1H induction.
BACKGROUND
In this study, we determined whether Campath-1H induction followed by sirolimus monotherapy inhibited alloantibody production in renal transplantation. Second, we evaluated the correlation between human leukocyte antigen (HLA) antibody production and serum creatinine levels.


METHODS
Sera were taken 1 to 24 months after transplantation from 24 patients treated with Campath-1H and sirolimus and tested for serum creatinine and HLA-specific antibody by using flow cytometry and enzyme-linked immunosorbent assay.


RESULTS
Ten (42%) of the 24 patients treated with Campath-1H and sirolimus produced HLA antibodies. Six of these 10 developed both donor-specific antibodies (DSAs) and non-donor-specific antibodies (NDSAs), whereas only NDSAs were detected in the other four patients. In patients with biopsy-diagnosed humoral rejection (C4d+), serum levels of both DSA and NDSA significantly correlated with patient serum creatinine levels. Rejection treatment successfully reduced both DSAs and NDSAs and reversed humoral rejection.


CONCLUSIONS
The numeric relationship between serum creatinine and DSA levels suggests a causal relationship between alloantibody and transplant rejection.
Cai
Junchao
J
Terasaki Foundation Laboratory, Los Angeles, California, USA.
Terasaki
Paul I
PI
Bloom
Debra D
DD
Torrealba
Jose R
JR
Friedl
Andreas
A
Sollinger
Hans W
HW
Knechtle
Stuart J
SJ
D000074323:Alemtuzumab; D000911:Antibodies, Monoclonal / Q000627:therapeutic use*; D061067:Antibodies, Monoclonal, Humanized; D000912:Antibodies, Neoplasm / Q000627:therapeutic use*; D000917:Antibody Formation / Q000276:immunology*; D018501:Antirheumatic Agents / Q000627:therapeutic use; D015704:CD4 Antigens / Q000276:immunology; D003404:Creatinine / Q000097:blood*; D004797:Enzyme-Linked Immunosorbent Assay; D005434:Flow Cytometry; D006084:Graft Rejection / Q000276:immunology; D006680:HLA Antigens / Q000276:immunology*; D006681:HLA-D Antigens / Q000276:immunology; D015395:Histocompatibility Antigens Class I / Q000276:immunology; D006801:Humans; D007166:Immunosuppressive Agents / Q000627:therapeutic use*; D016030:Kidney Transplantation / Q000276:immunology* / Q000473:pathology; D020123:Sirolimus / Q000627:therapeutic use*
D000911:Antibodies, Monoclonal; D061067:Antibodies, Monoclonal, Humanized; D000912:Antibodies, Neoplasm; D018501:Antirheumatic Agents; D015704:CD4 Antigens; D006680:HLA Antigens; D006681:HLA-D Antigens; D015395:Histocompatibility Antigens Class I; D007166:Immunosuppressive Agents; D000074323:Alemtuzumab; D003404:Creatinine; D020123:Sirolimus