title: Donor-derived HLA antibody production in patients undergoing SCT from HLA antibody-positive donors.
abstract: Pre-existing donor-specific HLA antibodies in patients undergoing HLA-mismatched SCT have increasingly been recognized as a risk factor for primary graft failure. However, the clinical implications of the presence of HLA antibodies in donors remain unknown. We prospectively examined 123 related donors for the presence of HLA antibodies by using a Luminex-based single antigen assay. Of these, 1/57 (1.8%) male, 6/27 (22%) parous female and 0/39 (0%) nonparous female donors were HLA antibody-positive. Then, we determined the presence of HLA antibodies in seven patients who received SCT from antibody-positive donors. Of these, four became HLA antibody-positive after SCT. The specificities of the antibodies that emerged in the patients closely resembled those of the antibodies found in the donors, indicating their production by donor-derived plasma cells. Moreover, the kinetics of the HLA antibody levels were similar in all four patients: levels started increasing within 1 week after SCT and peaked at days 10-21, followed by a gradual decrease. These results suggest that donor-derived HLA antibody production frequently occurs in patients undergoing SCT from antibody-positive donors. Further studies are warranted for clarifying the clinical significance of donor-derived HLA antibodies, including the role of these antibodies in post transplant platelet transfusion refractoriness.
authors.affiliation: Department of Internal Medicine, Division of Hematology, Hyogo College of Medicine, Hyogo, Japan.
authors.forename: K
authors.initials: K
authors.lastname: Taniguchi
authors.forename: S
authors.initials: S
authors.lastname: Yoshihara
authors.forename: E
authors.initials: E
authors.lastname: Maruya
authors.forename: K
authors.initials: K
authors.lastname: Ikegame
authors.forename: K
authors.initials: K
authors.lastname: Kaida
authors.forename: K
authors.initials: K
authors.lastname: Hayashi
authors.forename: R
authors.initials: R
authors.lastname: Kato
authors.forename: T
authors.initials: T
authors.lastname: Inoue
authors.forename: T
authors.initials: T
authors.lastname: Fujioka
authors.forename: H
authors.initials: H
authors.lastname: Tamaki
authors.forename: M
authors.initials: M
authors.lastname: Okada
authors.forename: T
authors.initials: T
authors.lastname: Onuma
authors.forename: N
authors.initials: N
authors.lastname: Fujii
authors.forename: Y
authors.initials: Y
authors.lastname: Kusunoki
authors.forename: T
authors.initials: T
authors.lastname: Soma
authors.forename: H
authors.initials: H
authors.lastname: Saji
authors.forename: H
authors.initials: H
authors.lastname: Ogawa
mesh_terms: D000328:Adult; D005260:Female; D006680:HLA Antigens; D006801:Humans; D007518:Isoantibodies / Q000097:blood* / Q000276:immunology; D008297:Male; D008875:Middle Aged; D010950:Plasma Cells / Q000276:immunology / Q000378:metabolism; D011446:Prospective Studies; D035781:Siblings; D033581:Stem Cell Transplantation; D013997:Time Factors; D061349:Unrelated Donors
chemical_list: D006680:HLA Antigens; D007518:Isoantibodies