Early Intervention in Living Kidney Transplantation Based on Dynamic Monitoring of Donor Specific Antibodies.
This study aims to analyze the clinical application of HLA donor specific antibodies (DSA) detected by Luminex single antigen beads and to discuss the impact of early intervention on renal function in DSA positive kidney transplant patients. In 64 cases of living-related renal transplantation, DSA was detected using Luminex single antigen bead assays before and after transplantation. The positive recipients were given intravenous immunoglobulin (IVIG) and increased doses of mycophenolate mofetil (MMF). The relationship between DSA and renal function was analyzed. In all transplant recipients, DSA was negative prior to transplantation. Ten DSA positive recipients were found after HLA mismatched transplantations. With intervention, two DSA positive recipients became DSA negative. In six cases, the patients' DSA intensity decreased more than 50%. In the remaining two cases, DSA intensity did not significantly decline, and within 3-6 months, antibody-mediated rejection (AMR) appeared and renal function was impaired. From our research, we conclude that dynamic monitoring of DSA using Luminex single antigen beads may help predict future changes in renal function. In addition, early application of IVIG and increasing doses of MMF can reduce the incidence of AMR.
Yu
Y
Chen
Lang-Yan
LY
Li
Xiao-Yan
XY
Lou
Hao
H
Wang
Lei
L
Zhang
You-Hua
YH
Zhu
D000328:Adult; D015415:Biomarkers / Q000097:blood; D004359:Drug Therapy, Combination; D005260:Female; D006084:Graft Rejection / Q000276:immunology / Q000517:prevention & control*; D006085:Graft Survival; D006680:HLA Antigens / Q000276:immunology*; D006648:Histocompatibility; D006801:Humans; D007166:Immunosuppressive Agents / Q000009:adverse effects / Q000627:therapeutic use*; D007518:Isoantibodies / Q000097:blood*; D016030:Kidney Transplantation / Q000009:adverse effects / Q000379:methods*; D019520:Living Donors; D008297:Male; D008875:Middle Aged; D015166:Monitoring, Immunologic / Q000379:methods*; D011237:Predictive Value of Tests; D012307:Risk Factors; D013997:Time Factors; D016896:Treatment Outcome; D055815:Young Adult
D015415:Biomarkers; D006680:HLA Antigens; D007166:Immunosuppressive Agents; D007518:Isoantibodies