title: [Anti-MICA antibodies: risk factors for sensitization and the impact on renal transplantation outcomes].
abstract: OBJECTIVE
  To investigate the risk factors for sensitization of anti-MICA antibodies and their impact on the outcomes of renal transplantation.
  
  
  METHODS
  Luminex flow cytometry were used to identify 10 MICA antibodies and evaluate the antibody specificity in 98 uremic patients positive or negative for anti-MICA antibodies undergoing kidney transplantation. The factors contributing to MICA sensitization were analyzed, and the incidence of acute rejection and graft function recovery time were compared between the positive and negative cases for anti-MICA antibodies.
  
  
  RESULTS
  Of the 98 uremic patients, 16 (16.3%) were positive for anti-MICA antibodies. The positive and negative cases showed significant differences in the history of blood transfusion, pregnancy, transplantation, and PRA status (P<0.05). In the 38 renal transplant recipients, 6 experienced acute graft rejection, which was reversed by methylprednisolone pulse therapy; of the 10 recipients positive for anti-MICA antibodies, 4 showed acute graft rejection as compared to 2 out of the 28 recipients negative for anti-MICA antibodies (P=0.031). The cases positive for anti-MICA antibodies showed a significantly longer graft function recovery time than the negative cases (14.6∓4.7 vs 8.2∓4.5 days, P=0.001).
  
  
  CONCLUSIONS
  Blood transfusion, pregnancy, and transplantation all contribute to the production of anti-MICA antibodies. Patients positive for anti-MICA antibodies may require strict HLA matching and more potent immunosuppressive drugs to prevent renal graft rejection and improve graft survival.
authors.affiliation: Department of Organ Transplantation, Nanfang Hospital, Southern Medical University, Guangzhou 510515, China. yulixin1@medmail.com.cn
authors.forename: Li-Xin
authors.initials: LX
authors.lastname: Yu
authors.forename: Gui
authors.initials: G
authors.lastname: Wang
authors.forename: Shao-Jie
authors.initials: SJ
authors.lastname: Fu
authors.forename: Lu-Lu
authors.initials: LL
authors.lastname: Xiao
authors.forename: Jian
authors.initials: J
authors.lastname: Xu
authors.forename: Chuan-Fu
authors.initials: CF
authors.lastname: DU
mesh_terms: D000328:Adult; D000888:Antibodies, Anti-Idiotypic / Q000276:immunology*; D000918:Antibody Specificity; D001803:Blood Transfusion; D005260:Female; D005805:Genes, MHC Class I / Q000276:immunology*; D006085:Graft Survival; D015395:Histocompatibility Antigens Class I / Q000276:immunology*; D006650:Histocompatibility Testing; D006801:Humans; D016030:Kidney Transplantation / Q000276:immunology*; D008297:Male; D008875:Middle Aged; D011247:Pregnancy; D012307:Risk Factors; D014511:Uremia / Q000276:immunology* / Q000601:surgery
chemical_list: D000888:Antibodies, Anti-Idiotypic; D015395:Histocompatibility Antigens Class I; C099187:MHC class I-related chain A