1. ELISA ANTI-HLA ANTIBODY SCREENING IDENTIFIES NON-COMPLEMENT-FIXING ANTIBODIES RESPONSIBLE FOR ACUTE GRAFT REJECTION. A CASE REPORT
- Author
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A. Vangelista, Maria Scolari, G. Liviano D’Arcangelo, L. B. De Sanctis, Vittorio Bonomini, Andrea Buscaroli, Sergio Stefoni, R. Buttazzi, Paola Todeschini, S. Iannelli, and A. Nanni-Costa
- Subjects
Adult ,Graft Rejection ,Male ,Urinary system ,Immunology ,Enzyme-Linked Immunosorbent Assay ,Human leukocyte antigen ,Flow cytometry ,HLA-B7 Antigen ,Immunopathology ,Genetics ,Humans ,Medicine ,Clinical significance ,Molecular Biology ,Genetics (clinical) ,Retrospective Studies ,Kidney ,medicine.diagnostic_test ,biology ,business.industry ,Complement Fixation Tests ,General Medicine ,Kidney Transplantation ,Transplantation ,medicine.anatomical_structure ,Immunoglobulin G ,biology.protein ,Antibody ,business - Abstract
We report on a kidney transplant recipient experiencing an unexpected early acute vascular graft rejection. Retrospective analysis of patient serum samples, utilizing a new ELISA HLA screening technique, revealed that the rejection crisis and the subsequent graft loss were due to a pretransplant donor-specific pre-sensitization caused by a non-complement-fixing antibody of IgG2 class. The case illustrates the clinical significance of non-complement-fixing anti-HLA antibodies. In addition it is shown that ELISA methods are suitable for detecting potentially harmful donor pre-sensitization in waiting-list patients not detectable by standard lymphocytotoxicity techniques. Hence ELISA could be an alternative to flow cytometry for this purpose. It is concluded that screening and cross-matching techniques which detect non-complement-fixing anti-HLA antibodies could improve graft outcome, and should form part of the immunological monitoring of kidney transplant waiting-list patients.
- Published
- 1996
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