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 journalArticlepeer-review

34 Scopus citations


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 languageEnglish (US)
Pages (from-to)307-310
Number of pages4
JournalNephrology Dialysis Transplantation
Issue number1
StatePublished - Jan 2010


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

ASJC Scopus subject areas

  • Nephrology
  • Transplantation


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