Antibody-mediated rejection following transplantation from an HLA-identical sibling

Carrie A. Grafft; Lynn D. Cornell; James M. Gloor; Fernando G. Cosio; Manish J. Gandhi; Patrick G. Dean; Mark D. Stegall; Hatem Amer

doi:10.1093/ndt/gfp526

Antibody-mediated rejection following transplantation from an HLA-identical sibling

Carrie A. Grafft, Lynn D. Cornell, James M. Gloor, Fernando G. Cosio, Manish J. Gandhi, Patrick G. Dean, Mark D. Stegall, Hatem Amer

Research output: Contribution to journal › Article › peer-review

34 Scopus citations

Abstract

Putative antibody-mediated rejection (AMR) in HLA-identical sibling transplantation has rarely been reported and occurred before routine calcineurin inhibitor use. A 29-year-old male developed allograft dysfunction following an HLA-identical renal transplant from his sibling. A pretransplant panel-reactive antibody (PRA) was elevated, pre-transplant crossmatch was negative and no donor-specific antibody (DSA) was identified. Induction with alemtuzumab was followed by maintenance immunosuppression with corticosteroids, tacrolimus and mycophenolate. A biopsy for allograft dysfunction suggested AMR, but DSA could not be detected. Treatment for rejection was transiently successful. Undetectable minor histocompatibility antibodies may have contributed.

Original language	English (US)
Pages (from-to)	307-310
Number of pages	4
Journal	Nephrology Dialysis Transplantation
Volume	25
Issue number	1
DOIs	https://doi.org/10.1093/ndt/gfp526
State	Published - Jan 2010

Keywords

Acute allograft dysfunction
Alemtuzumab
Limitations of testing
Living kidney donor
Minor histocompatibility antigens

ASJC Scopus subject areas

Nephrology
Transplantation

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10.1093/ndt/gfp526

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abstract = "Putative antibody-mediated rejection (AMR) in HLA-identical sibling transplantation has rarely been reported and occurred before routine calcineurin inhibitor use. A 29-year-old male developed allograft dysfunction following an HLA-identical renal transplant from his sibling. A pretransplant panel-reactive antibody (PRA) was elevated, pre-transplant crossmatch was negative and no donor-specific antibody (DSA) was identified. Induction with alemtuzumab was followed by maintenance immunosuppression with corticosteroids, tacrolimus and mycophenolate. A biopsy for allograft dysfunction suggested AMR, but DSA could not be detected. Treatment for rejection was transiently successful. Undetectable minor histocompatibility antibodies may have contributed.",

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AU - Grafft, Carrie A.

AU - Cornell, Lynn D.

AU - Gloor, James M.

AU - Cosio, Fernando G.

AU - Gandhi, Manish J.

AU - Dean, Patrick G.

AU - Stegall, Mark D.

AU - Amer, Hatem

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AB - Putative antibody-mediated rejection (AMR) in HLA-identical sibling transplantation has rarely been reported and occurred before routine calcineurin inhibitor use. A 29-year-old male developed allograft dysfunction following an HLA-identical renal transplant from his sibling. A pretransplant panel-reactive antibody (PRA) was elevated, pre-transplant crossmatch was negative and no donor-specific antibody (DSA) was identified. Induction with alemtuzumab was followed by maintenance immunosuppression with corticosteroids, tacrolimus and mycophenolate. A biopsy for allograft dysfunction suggested AMR, but DSA could not be detected. Treatment for rejection was transiently successful. Undetectable minor histocompatibility antibodies may have contributed.

KW - Acute allograft dysfunction

KW - Alemtuzumab

KW - Limitations of testing

KW - Living kidney donor

KW - Minor histocompatibility antigens

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Antibody-mediated rejection following transplantation from an HLA-identical sibling

Abstract

Keywords

ASJC Scopus subject areas

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