Donor-specific HLA antibody response in clonal deletion.
1. A total of 61 patients were treated with a clonal deletion protocol and transplanted without planned post-transplant immunosuppression. 2. Twenty-nine (48%) patients did not develop any donor-specific anti-HLA antibodies after the transplant, with a median follow-up of 158 days and a mean sCr of 2.1 mg/dL at the last follow-up. 3. Only 23% of the patients who received a DST of 60 mL produced DSA after the transplant, while 68% of the patients who received a bigger DST dose did. 4. Small doses of donor-specific transfusions (60 mL) elicited smaller specific responses, allowing efficient deletion of the reacting clones, creating conditions in which donor-specific anti-HLA antibodies were not produced. 5. A better deleting agent is needed to achieve higher rates of success using the clonal deletion protocol.
Kaneku
H
H
'erasaki Foundation Laboratory, Los Angeles, CA, USA.
Idica
A
A
Everly
M J
MJ
Terasaki
P I
PI
Feroz
A
A
Vanikar
A V
AV
Shankar
V
V
Trivedi
V B
VB
Modi
P R
PR
Khemchandani
S I
SI
Dave
S D
SD
Trivedi
H L
HL
D000293:Adolescent; D000328:Adult; D000906:Antibodies / Q000097:blood*; D002648:Child; D017637:Clonal Deletion; D005260:Female; D006084:Graft Rejection / Q000276:immunology / Q000517:prevention & control*; D006085:Graft Survival; D006680:HLA Antigens / Q000276:immunology*; D006648:Histocompatibility; D006801:Humans; D016030:Kidney Transplantation; D019520:Living Donors; D008297:Male; D008875:Middle Aged; D013997:Time Factors; D019172:Transplantation Conditioning / Q000379:methods*; D016896:Treatment Outcome; D055815:Young Adult
D000906:Antibodies; D006680:HLA Antigens