Kidney transplantation in a patient with preformed and exclusively anti-HLA-Cw donor specific antibody

We report a patient who had received a first kidney transplant and had preformed DSA anti-HLA-Cw, developing AMR C4d+ soon after transplant. Classically anti-HLA-Cw are considered less immunogenic and are not considered in many organ allocation systems or immunologic risk stratification algorithms,...

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Bibliographic Details
Main Author: Santos, S. (author)
Other Authors: Castro, A. (author), Campos, A. (author), Pedroso, S. (author), Dias, L. (author), Castro-Henriques, A. (author)
Format: article
Language:eng
Published: 2018
Subjects:
Donor-specific antibodies (DSA)
Anti-HLA-Cw antibodies
Antibody-mediated rejection (AMR)
Online Access:http://hdl.handle.net/10400.16/2245
Country:Portugal
Oai:oai:repositorio.chporto.pt:10400.16/2245
Description
Summary:We report a patient who had received a first kidney transplant and had preformed DSA anti-HLA-Cw, developing AMR C4d+ soon after transplant. Classically anti-HLA-Cw are considered less immunogenic and are not considered in many organ allocation systems or immunologic risk stratification algorithms, including in Portugal. However, data from literature confirms that their presence is as deleterious as DSA anti-HLA A/B/DR/DQ. Thus we should take HLA-C typing and respective antibody identification into account in sensitized patients, in order to access risk stratification and establish the need for correct induction or desensitization therapies.

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