Antibody-mediated rejection following transplantation from an HLA-identical sibling | Zendy

C. A. Grafft | Zendy; Lynn D. Cornell | Zendy; J.M. Gloor | Zendy; F. G. Cosio | Zendy; Manish J. Gandhi | Zendy; Patrick G. Dean | Zendy; Mark D. Stegall | Zendy; Hatem Amer | Zendy

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Antibody-mediated rejection following transplantation from an HLA-identical sibling

Author(s) -

C. A. Grafft,

Lynn D. Cornell,

J.M. Gloor,

F. G. Cosio,

Manish J. Gandhi,

Patrick G. Dean,

Mark D. Stegall,

Hatem Amer

Publication year - 2009

Publication title -

nephrology dialysis transplantation

Language(s) - English

Resource type - Journals

SCImago Journal Rank - 1.654

H-Index - 168

eISSN - 1460-2385

pISSN - 0931-0509

DOI - 10.1093/ndt/gfp526

Subject(s) - medicine , alemtuzumab , tacrolimus , calcineurin , human leukocyte antigen , immunosuppression , immunology , sibling , panel reactive antibody , histocompatibility , antibody , transplantation , isoantibodies , histocompatibility testing , antigen , psychology , developmental psychology

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.

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