title: HLA-A2 reactive antibodies in a patient who types as HLA-A2: The importance of high resolution typing and epitope-based antibody analysis.
abstract: This report describes a case of a highly sensitized patient who had serum antibodies reacting with HLA-A2 but whose phenotype included HLA-A2. The determination of HLA mismatch acceptability at the antigen level was problematic, but high-resolution HLA typing information and epitope-based antibody specificity analysis based on the nonself-self paradigm of HLA epitope immunogenicity have provided a solution. This case supports the concept that HLA typing at the allele level offers a better approach to identifying suitable donors for sensitized patients.
authors.affiliation: Transplantation Immunology Laboratory, Department of Surgery, Albany Medical College, Albany, NY, United States. Electronic address: hahna@mail.amc.edu.
authors.forename: A B
authors.initials: AB
authors.lastname: Hahn
authors.affiliation: Transplantation Immunology Laboratory, Department of Surgery, Albany Medical College, Albany, NY, United States.
authors.forename: V
authors.initials: V
authors.lastname: Bravo-Egana
authors.affiliation: Transplantation Immunology Laboratory, Department of Surgery, Albany Medical College, Albany, NY, United States.
authors.forename: J L
authors.initials: JL
authors.lastname: Jackstadt
authors.affiliation: Section of Transplantation, Department of Surgery, Albany Medical Center, Albany, NY, United States.
authors.forename: D J
authors.initials: DJ
authors.lastname: Conti
authors.affiliation: Thomas E. Starzl Transplantation Institute, University of Pittsburgh Medical Center, Pittsburgh, PA, United States.
authors.forename: R J
authors.initials: RJ
authors.lastname: Duquesnoy
mesh_terms: D000328:Adult; D000483:Alleles; D001323:Autoantibodies / Q000378:metabolism*; D018604:Epitope Mapping / Q000379:methods*; D000939:Epitopes / Q000276:immunology / Q000378:metabolism*; D005260:Female; D006084:Graft Rejection / Q000276:immunology*; D015789:HLA-A2 Antigen / Q000276:immunology / Q000378:metabolism*; D006648:Histocompatibility; D006650:Histocompatibility Testing; D006801:Humans; D007114:Immunization; D016030:Kidney Transplantation; D016035:Pancreas Transplantation; D012086:Reoperation
chemical_list: D001323:Autoantibodies; D000939:Epitopes; D015789:HLA-A2 Antigen
keywords: Antibody analysis; Epitope; HLA