Positive pre-transplant flow-panel reactive antibody detected after accelerated acute rejection with negative pre-transplant flow crossmatch

被引：4
|
作者：
Miura, Masayoshi
Kubota, Kanako C.
Itoh, Tomoo
Ono, Takenori
Morita, Ken
Watarai, Yoshihiko
Harada, Hiroshi
Hirano, Tetsuo
Nonomura, Katsuya
机构：
[1] Hokkaido Univ, Grad Sch Med, Dept Renal & Genitourinary Surg, Kita Ku, Sapporo, Hokkaido 0608648, Japan
[2] Hokkaido Univ Hosp, Dept Surg Pathol, Sapporo, Hokkaido 060, Japan
[3] Sapporo City Gen Hosp, Dept Renal Transplantat, Sapporo, Hokkaido, Japan
来源：
CLINICAL TRANSPLANTATION | 2006年 / 20卷
关键词：
antibody-mediated rejection; donor specific antibody; flow panel reactive antibody; renal transplantation;
D O I：
10.1111/j.1399-0012.2006.00547.x
中图分类号：
R61 [外科手术学];
学科分类号：
摘要：
A 30-yr-old woman underwent kidney transplantation from a flow cytometric lymphocyte crossmatch-negative donor. Immunosuppression consisted of tacrolimus, mycophenolate mofetil, basiliximab and three days of steroid. On day 5 post-transplant, she developed acute rejection and underwent anti-rejection therapy consisting of steroid pulse and deoxyspurgualin. Retrospective analyses of anti-human leukocyte antigen antibody revealed high flow panel reactive antibody (PRA) in the pre-transplant serum without donor specific antibody (DSA) and positive DSA at the time of rejection. Anti-rejection therapy was successful in treating cellular rejection but her graft function further deteriorated after three months post-transplant and graft biopsy revealed chronic allograft nephropathy with positive staining for C4d in peritubular capillary, suggesting the presence of chronic antibody-mediated rejection. Pre-transplant positive flow PRA without DSA may also be a risk for acute and chronic rejection.
引用
收藏
页码：33 / 37
页数：5
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