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Titolo:
Long term evaluation of proliferative donor antigen-specific reactivity incadaveric kidney transplant recipients
Autore:
Bohmig, GA; Saemann, MD; Bergmann, M; Watschinger, B; Regele, H; Windhager, T; Muhlbacher, F; Horl, WH; Zlabinger, GJ;
Indirizzi:
Univ Vienna, Dept Internal Med 3, A-1090 Vienna, Austria Univ Vienna Vienna Austria A-1090 Internal Med 3, A-1090 Vienna, Austria
Titolo Testata:
TRANSPLANT INTERNATIONAL
fascicolo: 3, volume: 13, anno: 2000,
pagine: 187 - 193
SICI:
0934-0874(200005)13:3<187:LTEOPD>2.0.ZU;2-7
Fonte:
ISI
Lingua:
ENG
Soggetto:
RENAL-ALLOGRAFT RECIPIENTS; CYCLOSPORINE; MLR; HYPORESPONSIVENESS; IMMUNOSUPPRESSION; UNRESPONSIVENESS; REJECTION;
Keywords:
donor antigen-specific reactivity; immunologic monitoring; mixed lymphocyte culture (MLC); rejection; transplantation;
Tipo documento:
Article
Natura:
Periodico
Settore Disciplinare:
Clinical Medicine
Citazioni:
26
Recensione:
Indirizzi per estratti:
Indirizzo: Zlabinger, GJ Univ Vienna, Inst Immunol, Borschkegasse 8A, A-1090 Vienna, Austria Univ Vienna Borschkegasse 8A Vienna Austria A-1090 Austria
Citazione:
G.A. Bohmig et al., "Long term evaluation of proliferative donor antigen-specific reactivity incadaveric kidney transplant recipients", TRANSPLAN I, 13(3), 2000, pp. 187-193

Abstract

Development of donor-specific proliferative hyporeactivity has been evaluated in many studies for its usefulness in identifying transplant recipientsat low risk of immunological complications. These studies often result in controversial conclusions, however. The authors claim that the discrepancy in the predictive value of mixed lymphocyte culture- (MLC) reactivity mightpartly be due to differences in presentation and interpretation of results. The purpose of this study is to investigate the usefulness of a normalized evaluation of antigen-specific donor-reactivity in a small number of kidney transplant recipients. This could then serve as a basis for an extended clinical study. Ten cadaveric kidney recipients were tested for proliferative reactivity to donor- and third-party antigens up to 20 months posttransplantation. Expressing donor-specific reactivity as a relation between the percentage of pretransplant responses towards donor splenocytes and the percentage of pretransplant responses towards third-party donor cells should minimize influences of e.g, uremia, current immunosuppression or infections on the evaluation of specific reactivity and thus should allow an evaluationof the donor-specificity of T-cell alloresponses independently of fluctuations in global responsiveness. Four of ten recipients acquired a state of donor-specific hyporeactivity (<75% relative specific reactivity) at 20 months posttransplantation (61 +/- 12%, mean +/- SD). Six patients were classified non-hyporeactive (98 +/- 10% mean relative specific reactivity). Relative specific reactivity did not correlate with the levels of general reactivity. Three of the four hyporeactive and four of the six non-hyporeactive patients developed acute rejection. Stable graft function at 20 months posttransplantation (serum creatinine less than or equal to 2 mg/dl) was not closely related to the reactivity status, as five of eight patients with well-functioning grafts did not develop relative specific hyporeactivity. One recipient with chronic rejection was classified hyporeactive. One non-hyporeactive patient lost his graft due to non-immunological causes. Our data suggest that posttransplant relative specific reactivity does not predict acute rejection. Downregulation of donor-specific reactivity might not be a prerequisite for stable graft function but could help identifying recipients whorequire less immunosuppression. This, however, remains to be established in a prospective immunosuppression-weaning study.

ASDD Area Sistemi Dipartimentali e Documentali, Università di Bologna, Catalogo delle riviste ed altri periodici
Documento generato il 19/09/20 alle ore 23:26:58