Monitoring of kidney and simultaneous pancreas-kidney transplantation rejection by release of donor-specific, soluble HLA class I.

Published

Journal Article

Using an HLA-A2-specific ELISA we monitored daily pretransplantation and posttransplantation sera from five kidney and eight simultaneous pancreas-kidney HLA-A2-negative recipients of HLA-A2-positive transplants during hospitalization. We found that, unlike liver transplants, neither kidney nor simultaneous pancreas-kidney transplants continuously secreted donor HLA proteins. However, three of four rejection episodes in kidney recipients and seven of seven rejection episodes in simultaneous pancreas-kidney recipients were accompanied by elevated serum levels of donor sHLA-A2 (> 5 ng/ml). In only one kidney patient was there a release of donor antigen without evidence of rejection, but in the simultaneous pancreas-kidney group most patients had at least one time point of detectable sHLA-A2 without strong evidence of kidney rejection. While total sHLA levels were also elevated during rejection, the rise in donor-specific sHLA was more dramatic when compared to pretransplantation background levels. We hypothesized that the release of donor sHLA class I proteins by transplanted organs might be a systemic indication of rejection in both pancreas and kidney allografts. The detection of donor sHLA in recipient sera could be an important noninvasive monitor of rejection, especially in the pancreas, which is currently difficult to monitor as a single-organ transplant.

Full Text

Duke Authors

Cited Authors

  • DeVito-Haynes, LD; Jankowska-Gan, E; Sollinger, HW; Knechtle, SJ; Burlingham, WJ

Published Date

  • July 1994

Published In

Volume / Issue

  • 40 / 3

Start / End Page

  • 191 - 201

PubMed ID

  • 7960963

Pubmed Central ID

  • 7960963

International Standard Serial Number (ISSN)

  • 0198-8859

Digital Object Identifier (DOI)

  • 10.1016/0198-8859(94)90069-8

Language

  • eng

Conference Location

  • United States