Immunological evaluation by panel reactive antibody (PRA) and determination of anti-HLA specificity is an important phase in the assessment of patients awaiting kidney transplant. The main causes of immunization are previous solid organ transplants, blood transfusions, and pregnancy; immunogenicity can also be triggered by vascularized tissue grafts. Immune induction by cryopreserved bone allografts is not yet fully understood. We report the case of a 19-year-old patient with osteosarcoma who underwent resection of the left proximal tibia with reconstruction using human bone in 1997 (donor typing: A3, A29 (19) - B44 (12), Bw4 - DR13 (6), DR7, DR52, DR53). The patient was subsequently placed on the waiting list for a cadaver donor kidney transplant because of chronic kidney failure caused by cisplatin toxicity. Pretransplant immunological screening using the CDC (complement dependent cytotoxicity) technique revealed a PRA of 63% and anti-A3 and anti-A68 antibodies. The presence of IgG antibody specificity against class I and class II donor antigens (specifically anti-A3, B44, DR7 antibodies) was highlighted using flow cytometry (Tepnel-Luminex). Further immunological studies using single HLA specificity analysis (LSA Class I - II - Tepnel-Luminex) detected direct antibodies against all donor antigen specificities. This is the first reported case of immune induction after a bone graft in a kidney transplant candidate. It underlines the importance of the availability of HLA typing data of all human allograft donors.

Mosconi G, Baraldi O, Fantinati C, Cappuccilli M, Corsini S, Zanelli P, et al. (2009). Anti-HLA antibodies after bone graft and their impact on kidney transplant programs. [Riscontri di anticorpi anti-HLA dopo trapianto di tessuto osseo. Impatto su programmi di trapianto di rene.]. GIORNALE ITALIANO DI NEFROLOGIA, S-45, 58-63.

Anti-HLA antibodies after bone graft and their impact on kidney transplant programs. [Riscontri di anticorpi anti-HLA dopo trapianto di tessuto osseo. Impatto su programmi di trapianto di rene.]

MOSCONI, GIOVANNI;BARALDI, OLGA;FANTINATI, CONCETTA;CAPPUCCILLI, MARIA;CORSINI, SERENA;BUSCAROLI, ANDREA;FELICIANGELI, GIORGIO;STEFONI, SERGIO
2009

Abstract

Immunological evaluation by panel reactive antibody (PRA) and determination of anti-HLA specificity is an important phase in the assessment of patients awaiting kidney transplant. The main causes of immunization are previous solid organ transplants, blood transfusions, and pregnancy; immunogenicity can also be triggered by vascularized tissue grafts. Immune induction by cryopreserved bone allografts is not yet fully understood. We report the case of a 19-year-old patient with osteosarcoma who underwent resection of the left proximal tibia with reconstruction using human bone in 1997 (donor typing: A3, A29 (19) - B44 (12), Bw4 - DR13 (6), DR7, DR52, DR53). The patient was subsequently placed on the waiting list for a cadaver donor kidney transplant because of chronic kidney failure caused by cisplatin toxicity. Pretransplant immunological screening using the CDC (complement dependent cytotoxicity) technique revealed a PRA of 63% and anti-A3 and anti-A68 antibodies. The presence of IgG antibody specificity against class I and class II donor antigens (specifically anti-A3, B44, DR7 antibodies) was highlighted using flow cytometry (Tepnel-Luminex). Further immunological studies using single HLA specificity analysis (LSA Class I - II - Tepnel-Luminex) detected direct antibodies against all donor antigen specificities. This is the first reported case of immune induction after a bone graft in a kidney transplant candidate. It underlines the importance of the availability of HLA typing data of all human allograft donors.
2009
Mosconi G, Baraldi O, Fantinati C, Cappuccilli M, Corsini S, Zanelli P, et al. (2009). Anti-HLA antibodies after bone graft and their impact on kidney transplant programs. [Riscontri di anticorpi anti-HLA dopo trapianto di tessuto osseo. Impatto su programmi di trapianto di rene.]. GIORNALE ITALIANO DI NEFROLOGIA, S-45, 58-63.
Mosconi G; Baraldi O; Fantinati C; Cappuccilli M; Corsini S; Zanelli P; Bassi A; Buscaroli A; Feliciangeli G; Stefoni S.
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Utilizza questo identificativo per citare o creare un link a questo documento: https://hdl.handle.net/11585/76091
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