Donor-specific HLA antibody response in clonal deletion

Clin Transpl. 2008:189-98.

Abstract

1. A total of 61 patients were treated with a clonal deletion protocol and transplanted without planned post-transplant immunosuppression. 2. Twenty-nine (48%) patients did not develop any donor-specific anti-HLA antibodies after the transplant, with a median follow-up of 158 days and a mean sCr of 2.1 mg/dL at the last follow-up. 3. Only 23% of the patients who received a DST of 60 mL produced DSA after the transplant, while 68% of the patients who received a bigger DST dose did. 4. Small doses of donor-specific transfusions (60 mL) elicited smaller specific responses, allowing efficient deletion of the reacting clones, creating conditions in which donor-specific anti-HLA antibodies were not produced. 5. A better deleting agent is needed to achieve higher rates of success using the clonal deletion protocol.

MeSH terms

  • Adolescent
  • Adult
  • Antibodies / blood*
  • Child
  • Clonal Deletion*
  • Female
  • Graft Rejection / immunology
  • Graft Rejection / prevention & control*
  • Graft Survival
  • HLA Antigens / immunology*
  • Histocompatibility*
  • Humans
  • Kidney Transplantation*
  • Living Donors*
  • Male
  • Middle Aged
  • Time Factors
  • Transplantation Conditioning / methods*
  • Treatment Outcome
  • Young Adult

Substances

  • Antibodies
  • HLA Antigens