title: Significance of qualitative and quantitative evaluations of anti-HLA antibodies in kidney transplantation.
abstract: In this study, we retrospectively investigated the relationship between the presence/titers of donor-specific (DSA)/nondonor-specific antibody (NDSA) and the rate of graft rejection after transplantation. The subjects comprised 34 recipients who tested positive by FlowPRA(®) Screening. The recipients were divided into two groups; 22 recipients with DSA and 12 recipients with NDSA, as detected using FlowPRA(®) Single Antigen I and II beads. The antibodies were also quantitatively examined using the molecules of equivalent soluble fluorochrome (MESF) method. Nine of the 22 recipients with DSA (9/22, 40%) developed antibody-mediated rejection (AMR), while none of the 12 recipients with NDSA (0/12, 0%) developed AMR (P < 0.01). In a quantitative analysis of the MESF data, patients with DSA with MESF values of over 3000 frequently showed AMR (8/11, 73%). In contrast, one of the patients with DSA with MESF values of <3000 showed AMR (1/11, 9%). One of the 12 patients (1/12, 8%) with NDSA showed cellular rejection (T-cell-mediated rejection), regardless of the MESF values. In patients with DSA, an MESF value of 3000 may be a useful cutoff value for identifying patients at a high risk for AMR.
authors.affiliation: Department of Urology, Tokyo Women's Medical University, Shinjuku-ku, Tokyo, Japan. tgphide@gol.com
authors.forename: Hideki
authors.initials: H
authors.lastname: Ishida
authors.forename: Toshihito
authors.initials: T
authors.lastname: Hirai
authors.forename: Naoki
authors.initials: N
authors.lastname: Kohei
authors.forename: Yutaka
authors.initials: Y
authors.lastname: Yamaguchi
authors.forename: Kazunari
authors.initials: K
authors.lastname: Tanabe
mesh_terms: D000328:Adult; D000906:Antibodies / Q000032:analysis*; D005260:Female; D006084:Graft Rejection / Q000276:immunology* / Q000473:pathology; D006680:HLA Antigens / Q000276:immunology*; D006801:Humans; D016030:Kidney Transplantation / Q000276:immunology*; D019520:Living Donors; D008297:Male; D008875:Middle Aged; D013601:T-Lymphocytes / Q000276:immunology
chemical_list: D000906:Antibodies; D006680:HLA Antigens