Proinflammatory events are associated with significant increases in breadth and strength of HLA-specific antibody

J. E. Locke, A. A. Zachary, D. S. Warren, D. L. Segev, J. A. Houp, R. A. Montgomery, M. S. Leffell

Research output: Contribution to journalArticle

Abstract

Identification of factors responsible for an increase in the breadth or strength of HLA-specific antibody (HSA) is critical to the continued successful management and transplantation of sensitized patients. A retrospective review of our HLA registry identified 107 patients with known HSA and sufficient information in their electronic patient record to determine the presence or absence of a proinflammatory event. The patients were stratified according to transplant status [sensitized and on the transplant waitlist (n = 65); immunosuppressed recipients of a positive crossmatch (+XM) transplant (n = 42)]. Eighty-three percent of waitlist candidates and 55% of sensitized kidney transplant recipients with a documented proinflammatory event had an associated increase in HSA. Interestingly, among patients with a culture-proven infection, 97% of the waitlist patients and 54.8% of +XM recipients had an associated rise in HSA. Overall, proinflammatory events were associated with a greater increase among waitlist patients than +XM recipients, 5.3-fold [IRR 5.25, (95% CI 4.03-6.85), p < 0.001] versus 2.5-fold [IRR 2.54, (95% CI 1.64-3.95), p < 0.001] increase in HSA. Therefore, sensitized patients known to have an infection or undergoing surgery should be monitored for expansion of HSA.

Original languageEnglish (US)
Pages (from-to)2136-2139
Number of pages4
JournalAmerican Journal of Transplantation
Volume9
Issue number9
DOIs
StatePublished - Sep 2009

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Keywords

  • Human leukocyte antigen antibodies
  • Kidney transplantation
  • Sensitized patients
  • Waiting list

ASJC Scopus subject areas

  • Immunology and Allergy
  • Transplantation
  • Pharmacology (medical)

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