BACKGROUND: In this study, we determined whether Campath-1H induction followed by sirolimus monotherapy inhibited alloantibody production in renal transplantation. Second, we evaluated the correlation between human leukocyte antigen (HLA) antibody production and serum creatinine levels. METHODS: Sera were taken 1 to 24 months after transplantation from 24 patients treated with Campath-1H and sirolimus and tested for serum creatinine and HLA-specific antibody by using flow cytometry and enzyme-linked immunosorbent assay. RESULTS: Ten (42%) of the 24 patients treated with Campath-1H and sirolimus produced HLA antibodies. Six of these 10 developed both donor-specific antibodies (DSAs) and non-donor-specific antibodies (NDSAs), whereas only NDSAs were detected in the other four patients. In patients with biopsy-diagnosed humoral rejection (C4d+), serum levels of both DSA and NDSA significantly correlated with patient serum creatinine levels. Rejection treatment successfully reduced both DSAs and NDSAs and reversed humoral rejection. CONCLUSIONS: The numeric relationship between serum creatinine and DSA levels suggests a causal relationship between alloantibody and transplant rejection.
BACKGROUND: In this study, we determined whether Campath-1H induction followed by sirolimus monotherapy inhibited alloantibody production in renal transplantation. Second, we evaluated the correlation between human leukocyte antigen (HLA) antibody production and serum creatinine levels. METHODS: Sera were taken 1 to 24 months after transplantation from 24 patients treated with Campath-1H and sirolimus and tested for serum creatinine and HLA-specific antibody by using flow cytometry and enzyme-linked immunosorbent assay. RESULTS: Ten (42%) of the 24 patients treated with Campath-1H and sirolimus produced HLA antibodies. Six of these 10 developed both donor-specific antibodies (DSAs) and non-donor-specific antibodies (NDSAs), whereas only NDSAs were detected in the other four patients. In patients with biopsy-diagnosed humoral rejection (C4d+), serum levels of both DSA and NDSA significantly correlated with patient serum creatinine levels. Rejection treatment successfully reduced both DSAs and NDSAs and reversed humoral rejection. CONCLUSIONS: The numeric relationship between serum creatinine and DSA levels suggests a causal relationship between alloantibody and transplant rejection.
Authors: E K Page; A J Page; J Kwun; A C Gibby; F Leopardi; J B Jenkins; E A Strobert; M Song; R A Hennigar; N Iwakoshi; S J Knechtle Journal: Am J Transplant Date: 2012-07-09 Impact factor: 8.086
Authors: C A Schinstock; F Cosio; W Cheungpasitporn; D M Dadhania; M J Everly; M D Samaniego-Picota; L Cornell; M D Stegall Journal: Am J Transplant Date: 2017-01-25 Impact factor: 8.086
Authors: John C LaMattina; Joshua D Mezrich; R Michael Hofmann; David P Foley; Anthony M D'Alessandro; Hans W Sollinger; John D Pirsch Journal: Transpl Int Date: 2012-03-06 Impact factor: 3.782
Authors: J Kwun; B C Oh; A C Gibby; R Ruhil; V T Lu; D W Kim; E K Page; O P Bulut; M Q Song; A B Farris; A D Kirk; S J Knechtle; N N Iwakoshi Journal: Am J Transplant Date: 2012-07-03 Impact factor: 8.086
Authors: Ronald F Parsons; Kumar Vivek; Robert R Redfield; Thi-Sau Migone; Michael P Cancro; Ali Naji; Hooman Noorchashm Journal: Expert Rev Clin Immunol Date: 2009-11 Impact factor: 4.473