Pre-transplant Screening for Non-HLA Antibodies: Who should be Tested?

Retrospective studies of angiotensin II type 1 receptor antibodies (AT1R-Ab) and anti-endothelial cell antibodies (AECA) have linked these antibodies to allograft injury. Because rising healthcare costs dictate judicious use of laboratory testing, we sought to define characteristics of kidney transp...

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Bibliographic Details
Published in:Human immunology 2018-04, Vol.79 (4), p.195-202
Main Authors: Philogene, Mary Carmelle, Zhou, Sheng, Lonze, Bonnie E., Bagnasco, Serena, Alasfar, Sami, Montgomery, Robert A., Kraus, Edward, Jackson, Annette M., Leffell, Mary S., Zachary, Andrea A.
Format: Article
Language:English
Subjects:
Angiotensin II type 1 receptor antibody
Anti-endothelial cell antibodies
High immunologic risk patients
Kidney allograft dysfunction
Non-HLA antibodies
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Summary:Retrospective studies of angiotensin II type 1 receptor antibodies (AT1R-Ab) and anti-endothelial cell antibodies (AECA) have linked these antibodies to allograft injury. Because rising healthcare costs dictate judicious use of laboratory testing, we sought to define characteristics of kidney transplant recipients who may benefit from screening for non-HLA antibodies. Kidney recipients transplanted between 2011 and 2016 at Johns Hopkins, were evaluated for AT1R-Ab and AECA. Pre-transplant antibody levels were compared to clinical and biopsy indications of graft dysfunction. Biopsies were graded using the Banff' 2009–2013 criteria. AT1R-Ab and AECA were detected using ELISA and endothelial cell crossmatches, respectively. AT1R-Ab levels were higher in patients who were positive for AECAs. Re-transplanted patients (p 
ISSN:0198-8859
1879-1166
DOI:10.1016/j.humimm.2018.02.001