title: Monitoring of circulating antibodies in a renal transplantation population: preliminary results.
abstract: BACKGROUND
  The presence of circulating antibodies (CA) against human leukocyte antigen (HLA) and major-histocompatibility-complex class I-related chain A (MICA) antigens has been associated with worse renal function and reduced kidney allograft survival. We sought to describe the presence of donor-specific anti-HLA antibodies, non-donor specific antibodies, and antibodies against MICA antigens among a cohort of renal transplant recipients with respect to their evolution effects on renal function and occurrence of an acute rejection episode (AR) after transplantation.
  
  
  METHODS
  This prospective study of 22 renal transplant recipients of deceased donor kidneys underwent studies of antibodies before and 3 months after grafting using Luminex technology.
  
  
  RESULTS
  Ten patients (five men and five women) showed preexistent CA. Comparing patients with versus without preformed CA, we did not observe a significant difference in donor and recipient age or gender. Eight patients (80%) with CA had undergone induction treatment with anti-human-activated T-lymphocyte rabbit immunoglobulin and 2 (20%) with basiliximab. There were no differences between groups regarding the incidence of acute rejection episodes (ARE n = 3 each). There was one case of Banff grade IIB ARE in a patient without preexisting CA; the other episodes were low-grade cellular responses. There were no differences in other variables including cold ischemia time, HLA mismatches, panel-reactive antibody levels, number of transfusions, cytomegalovirus infection or renal function at discharge and 3 months later. Retransplantation was the only factor associated with preformed CA. Retransplantation and preformed CA were associated with CA at 3 months after transplantation.
  
  
  CONCLUSIONS
  CA monitoring is important for highly sensitized renal transplants, although our experience failed to show a difference in graft survival or renal function in the first 3 months' follow-up.
authors.affiliation: Nephrology Department, Hospital General Universitario Gregorio Marañón, Madrid, Spain. mlrodriguezf@senefro.org
authors.forename: M L
authors.initials: ML
authors.lastname: Rodríguez Ferrero
authors.forename: D
authors.initials: D
authors.lastname: Arroyo
authors.forename: N
authors.initials: N
authors.lastname: Panizo
authors.forename: J L
authors.initials: JL
authors.lastname: Vicario
authors.forename: A
authors.initials: A
authors.lastname: Balas
authors.forename: F
authors.initials: F
authors.lastname: Anaya
mesh_terms: D000208:Acute Disease; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000911:Antibodies, Monoclonal / Q000627:therapeutic use; D000961:Antilymphocyte Serum / Q000627:therapeutic use; D000077552:Basiliximab; D015415:Biomarkers / Q000097:blood; D005260:Female; D006084:Graft Rejection / Q000453:epidemiology / Q000276:immunology / Q000601:surgery; D006680:HLA Antigens / Q000276:immunology*; D015395:Histocompatibility Antigens Class I / Q000276:immunology*; D006801:Humans; D007166:Immunosuppressive Agents / Q000627:therapeutic use; D015994:Incidence; D007518:Isoantibodies / Q000097:blood*; D016030:Kidney Transplantation / Q000009:adverse effects / Q000276:immunology*; D008297:Male; D008875:Middle Aged; D015166:Monitoring, Immunologic; D011446:Prospective Studies; D011993:Recombinant Fusion Proteins / Q000627:therapeutic use; D012086:Reoperation; D012307:Risk Factors; D013030:Spain / Q000453:epidemiology; D013997:Time Factors; D016896:Treatment Outcome
chemical_list: D000911:Antibodies, Monoclonal; D000961:Antilymphocyte Serum; D015415:Biomarkers; D006680:HLA Antigens; D015395:Histocompatibility Antigens Class I; D007166:Immunosuppressive Agents; D007518:Isoantibodies; C099187:MHC class I-related chain A; D011993:Recombinant Fusion Proteins; D000077552:Basiliximab