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3 results on '"Mixed acute rejection"'

1. Management of mixed acute rejection driven by a de novo donor-specific complement-binding anti-DQB1*03:01 antibody and intraepithelial CD8 T-cells in a kidney recipient: a case report

Author

A Rodríguez-Campón, G Tabernero, P Fraile, Francisco Boix, María C. Chillón, Ramón García-Sanz, S García-Sánchez, J Feito, and Junta de Castilla y León

Subjects
Donor specific antibodies, Microbiology (medical), T-cell mediated rejection, Transplant recipient, Clinical Biochemistry, Immunology, Desensitization, Human leukocyte antigen, Microbiology, 03 medical and health sciences, 0302 clinical medicine, Rescue therapy, medicine, Immunology and Allergy, Cytotoxic T cell, Mixed acute rejection, 0303 health sciences, Kidney, biology, medicine.diagnostic_test, 030306 microbiology, business.industry, Biochemistry (medical), HLA, surgical procedures, operative, Infectious Diseases, medicine.anatomical_structure, Antibody-mediated rejection, 030220 oncology & carcinogenesis, biology.protein, Complement binding, Renal biopsy, Antibody, business, CD8
Abstract

Mixed acute rejection is a clinicopathological entity that is difficult to accurately diagnose, and so may be under-reported. Allografts are lost more often than in either humoral or cellular rejection. The diagnosis requires both histological and immunological studies on renal biopsy and blood specimens from the transplant recipient to provide the required rescue therapy to abolish the allogeneic response against the graft. We present a clinical case report of an active mixed acute rejection driven by a de novo donor-specific complement-binding anti-DQB1*03:01 antibody and intraepithelial CD8 T-cells in a patient with a kidney transplant. The patient was diagnosed, treated, and followed up as per the local institution’s procedure with a full recovery of graft function. Our case emphasises the challenge of a mixed acute rejection and supports the need to improve the post-transplant outcome of recipients and their grafts., This work was partially funded by the Gerencia Regional de Salud (GRS) of Castilla y León [GRS 2080/A/19].

Published
2021
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2. Management of mixed acute rejection driven by a de novo donor-specific complement-binding anti-DQB1*03:01 antibody and intraepithelial CD8 T-cells in a kidney recipient: a case report

Author

Junta de Castilla y León, Boix, Francisco, Feito, J., Rodríguez-Campón, A., Chillón, M. del Carmen, García-Sánchez, S., Tabernero, G., Fraile, Pilar, García-Sanz, Ramón, Junta de Castilla y León, Boix, Francisco, Feito, J., Rodríguez-Campón, A., Chillón, M. del Carmen, García-Sánchez, S., Tabernero, G., Fraile, Pilar, and García-Sanz, Ramón

Abstract

Mixed acute rejection is a clinicopathological entity that is difficult to accurately diagnose, and so may be under-reported. Allografts are lost more often than in either humoral or cellular rejection. The diagnosis requires both histological and immunological studies on renal biopsy and blood specimens from the transplant recipient to provide the required rescue therapy to abolish the allogeneic response against the graft. We present a clinical case report of an active mixed acute rejection driven by a de novo donor-specific complement-binding anti-DQB1*03:01 antibody and intraepithelial CD8 T-cells in a patient with a kidney transplant. The patient was diagnosed, treated, and followed up as per the local institution’s procedure with a full recovery of graft function. Our case emphasises the challenge of a mixed acute rejection and supports the need to improve the post-transplant outcome of recipients and their grafts.

Published
2021

3. Rat renal transplant model for mixed acute humoral and cellular rejection: Weak correlation of serum cytokines/chemokines with intragraft changes.

Author

Lemke, Anja, Noriega, Mercedes, Röske, Anja M., Kemper, Markus J., Nashan, Björn, Falk, Christine S., and Koch, Martina

Subjects
*HOMOGRAFTS, *BLOOD serum analysis, *KIDNEY transplantation, *GRAFT rejection, *MAJOR histocompatibility complex, *LABORATORY rats
Abstract

Background Acute renal allograft rejection remains a major cause of allograft dysfunction; especially for episodes with mixed humoral and cellular character which can be detrimental for graft survival. We established a rat RT model with exclusive and complete MHC-disparity to investigate pathomechanisms of acute rejection and evaluate serum multiplex assays as a diagnostic tool in this context. Methods LEW rats receive congeneic LEW.1W allografts (allo), no immunosuppression. Planned duration of the experiment was 4 weeks (n = 13 allo, n = 3 iso). To study kinetics of rejection, additional animals were sacrificed at day 7 (n = 6 allo and n = 3 iso) and day 21 (n = 3 allo). Serum cytokines and chemokine were longitudinally analyzed with multiplex assays in n = 5 allo and n = 5 controls. Allografts were assessed by histopathology, immunohisto-chemistry and PCR. Results Animals develop allograft dysfunction acute humoral rejection with additional cellular components. Donor-specific MHC-antibodies are already detectable at day seven (d7) after RT. Leukocytic graft infiltrates are dominated by macrophages and additionally consist of T-cells, B-cells and NK-cells. Increased intragraft expression of interleukin-2, interferon gamma, tumor necrosis factor alpha as well as B-cell activating factor and its receptor are observed. Of the 24 serum cytokines/chemokines, only CCL2 is significantly different (higher) in allo vs. controls at d7 (p = 0.02). Conclusions Correlation of serum chemokines/cytokines with features of humoral and cellular rejection, as reproduced in our LEW.1W to LEW rat renal transplant model, is limited. Macrophages, B-cells and their signaling pathways deserve more attention in genesis and possibly also treatment of acute rejection. [ABSTRACT FROM AUTHOR]

Published
2015
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