Antibody-mediated rejection following transplantation from an HLA-identical sibling.
Putative antibody-mediated rejection (AMR) in HLA-identical sibling transplantation has rarely been reported and occurred before routine calcineurin inhibitor use. A 29-year-old male developed allograft dysfunction following an HLA-identical renal transplant from his sibling. A pretransplant panel-reactive antibody (PRA) was elevated, pre-transplant crossmatch was negative and no donor-specific antibody (DSA) was identified. Induction with alemtuzumab was followed by maintenance immunosuppression with corticosteroids, tacrolimus and mycophenolate. A biopsy for allograft dysfunction suggested AMR, but DSA could not be detected. Treatment for rejection was transiently successful. Undetectable minor histocompatibility antibodies may have contributed.
Grafft
Carrie A
CA
Division of Nephrology and Hypertension, Department of Internal Medicine, Mayo Clinic, Rochester, MN, USA.
Cornell
Lynn D
LD
Gloor
James M
JM
Cosio
Fernando G
FG
Gandhi
Manish J
MJ
Dean
Patrick G
PG
Stegall
Mark D
MD
Amer
Hatem
H
D000328:Adult; D001706:Biopsy; D006084:Graft Rejection / Q000276:immunology*; D006680:HLA Antigens / Q000276:immunology*; D006801:Humans; D007668:Kidney / Q000473:pathology; D016030:Kidney Transplantation / Q000276:immunology*; D008297:Male; D035781:Siblings; D014184:Transplantation, Homologous
D006680:HLA Antigens