Antibody-mediated rejection of renal allograft in combined liver-kidney transplant

Rolf N. Barth, Luis Campos, Debra L. Kukuruga, Cinthia Drachenberg, Benjamin Philosophe

Research output: Contribution to journalArticle

Abstract

Liver transplantation is performed based on ABO blood type compatibility without dependence on crossmatch results. Combined liver-kidney transplantation (CLKT) is similarly performed without dependence of crossmatch results as the liver is thought to confer protection to the renal allograft against alloantibody. We report a case of CLKT in a sensitized patient with antibody-mediated rejection (AMR) of the renal allograft. AMR was confirmed with C4d staining and serial monitoring of donor-specific antibody (DSA). Despite intensive therapy directed against AMR and the presence of the liver allograft, the patient demonstrated increasing titers of alloantibody, never demonstrated adequate renal function, and ultimately expired after two months. This result demonstrates the potential for AMR of the renal allograft in sensitized recipients of CLKT.

Original languageEnglish (US)
Pages (from-to)685-690
Number of pages6
JournalClinical Transplantation
Volume24
Issue number5
DOIs
StatePublished - Sep 2010
Externally publishedYes

Fingerprint

Allografts
Liver Transplantation
Transplants
Kidney
Antibodies
Liver
Kidney Transplantation
Isoantibodies
Tissue Donors
Staining and Labeling
Therapeutics

Keywords

  • C4d
  • Cross-reactive groups
  • Donor-specific antibody
  • Humoral
  • Sensitized

ASJC Scopus subject areas

  • Transplantation

Cite this

Antibody-mediated rejection of renal allograft in combined liver-kidney transplant. / Barth, Rolf N.; Campos, Luis; Kukuruga, Debra L.; Drachenberg, Cinthia; Philosophe, Benjamin.

In: Clinical Transplantation, Vol. 24, No. 5, 09.2010, p. 685-690.

Research output: Contribution to journalArticle

Barth, Rolf N. ; Campos, Luis ; Kukuruga, Debra L. ; Drachenberg, Cinthia ; Philosophe, Benjamin. / Antibody-mediated rejection of renal allograft in combined liver-kidney transplant. In: Clinical Transplantation. 2010 ; Vol. 24, No. 5. pp. 685-690.
@article{f8c74a03b37640a98eb8020dd87957ec,
title = "Antibody-mediated rejection of renal allograft in combined liver-kidney transplant",
abstract = "Liver transplantation is performed based on ABO blood type compatibility without dependence on crossmatch results. Combined liver-kidney transplantation (CLKT) is similarly performed without dependence of crossmatch results as the liver is thought to confer protection to the renal allograft against alloantibody. We report a case of CLKT in a sensitized patient with antibody-mediated rejection (AMR) of the renal allograft. AMR was confirmed with C4d staining and serial monitoring of donor-specific antibody (DSA). Despite intensive therapy directed against AMR and the presence of the liver allograft, the patient demonstrated increasing titers of alloantibody, never demonstrated adequate renal function, and ultimately expired after two months. This result demonstrates the potential for AMR of the renal allograft in sensitized recipients of CLKT.",
keywords = "C4d, Cross-reactive groups, Donor-specific antibody, Humoral, Sensitized",
author = "Barth, {Rolf N.} and Luis Campos and Kukuruga, {Debra L.} and Cinthia Drachenberg and Benjamin Philosophe",
year = "2010",
month = "9",
doi = "10.1111/j.1399-0012.2009.01161.x",
language = "English (US)",
volume = "24",
pages = "685--690",
journal = "Clinical Transplantation",
issn = "0902-0063",
publisher = "Wiley-Blackwell",
number = "5",

}

TY - JOUR

T1 - Antibody-mediated rejection of renal allograft in combined liver-kidney transplant

AU - Barth, Rolf N.

AU - Campos, Luis

AU - Kukuruga, Debra L.

AU - Drachenberg, Cinthia

AU - Philosophe, Benjamin

PY - 2010/9

Y1 - 2010/9

N2 - Liver transplantation is performed based on ABO blood type compatibility without dependence on crossmatch results. Combined liver-kidney transplantation (CLKT) is similarly performed without dependence of crossmatch results as the liver is thought to confer protection to the renal allograft against alloantibody. We report a case of CLKT in a sensitized patient with antibody-mediated rejection (AMR) of the renal allograft. AMR was confirmed with C4d staining and serial monitoring of donor-specific antibody (DSA). Despite intensive therapy directed against AMR and the presence of the liver allograft, the patient demonstrated increasing titers of alloantibody, never demonstrated adequate renal function, and ultimately expired after two months. This result demonstrates the potential for AMR of the renal allograft in sensitized recipients of CLKT.

AB - Liver transplantation is performed based on ABO blood type compatibility without dependence on crossmatch results. Combined liver-kidney transplantation (CLKT) is similarly performed without dependence of crossmatch results as the liver is thought to confer protection to the renal allograft against alloantibody. We report a case of CLKT in a sensitized patient with antibody-mediated rejection (AMR) of the renal allograft. AMR was confirmed with C4d staining and serial monitoring of donor-specific antibody (DSA). Despite intensive therapy directed against AMR and the presence of the liver allograft, the patient demonstrated increasing titers of alloantibody, never demonstrated adequate renal function, and ultimately expired after two months. This result demonstrates the potential for AMR of the renal allograft in sensitized recipients of CLKT.

KW - C4d

KW - Cross-reactive groups

KW - Donor-specific antibody

KW - Humoral

KW - Sensitized

UR - http://www.scopus.com/inward/record.url?scp=78650505608&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=78650505608&partnerID=8YFLogxK

U2 - 10.1111/j.1399-0012.2009.01161.x

DO - 10.1111/j.1399-0012.2009.01161.x

M3 - Article

C2 - 19925465

AN - SCOPUS:78650505608

VL - 24

SP - 685

EP - 690

JO - Clinical Transplantation

JF - Clinical Transplantation

SN - 0902-0063

IS - 5

ER -