Skip to main content
construction release_alert
Scholars@Duke will be undergoing maintenance April 11-15. Some features may be unavailable during this time.
cancel
Journal cover image

IgG4 donor-specific HLA antibody profile is associated with subclinical rejection in stable pediatric liver recipients.

Publication ,  Journal Article
Jackson, AM; Kanaparthi, S; Burrell, BE; Lucas, DP; Vega, RM; Demetris, AJ; Feng, S
Published in: Am J Transplant
February 2020

The impact of donor-specific HLA antibody (DSA) following liver transplantation remains controversial. We hypothesized DSA IgG subclass characteristics, compared to total DSA IgG, might correlate with specific histopathological phenotype(s) of subclinical graft injury. We therefore studied 129 stable, arguably "clinically ideal," pediatric liver recipients at the time of a screening biopsy to enter an immunosuppression withdrawal trial. Sixty-five (50%) subjects tested positive for class II DSA. IgG subclass profile was characterized by mean fluorescence intensity (MFI) and normalized subclass composition (>5%). A prominent IgG4 DSA profile was strongly correlated with greater HLA mismatch, a histopathological phenotype characterized by the presence of interface activity (with variable degrees of fibrosis), and a transcriptional profile of attenuated T cell-mediated rejection. Specifically, compared to those without class II DSA, those with IgG4 class II DSA MFI sum >2000 exhibited an odds ratio (OR) of 20.79 (95% confidence interval [CI] 4.38-98.69) and IgG4 subclass composition >5% exhibited an OR of 8.99 (95% CI 2.70-29.9). Our data suggest that IgG4 DSA may serve as a useful biomarker to identify, among clinically and biochemically stable liver transplant recipients, a subset with histological and transcriptional features indicative of an active, suboptimally controlled alloimmune response.

Duke Scholars

Published In

Am J Transplant

DOI

EISSN

1600-6143

Publication Date

February 2020

Volume

20

Issue

2

Start / End Page

513 / 524

Location

United States

Related Subject Headings

  • Tissue Donors
  • Surgery
  • Reproducibility of Results
  • Prospective Studies
  • Male
  • Liver Transplantation
  • Isoantibodies
  • Immunosuppressive Agents
  • Immunoglobulin G
  • Humans
 

Citation

APA
Chicago
ICMJE
MLA
NLM
Jackson, A. M., Kanaparthi, S., Burrell, B. E., Lucas, D. P., Vega, R. M., Demetris, A. J., & Feng, S. (2020). IgG4 donor-specific HLA antibody profile is associated with subclinical rejection in stable pediatric liver recipients. Am J Transplant, 20(2), 513–524. https://doi.org/10.1111/ajt.15621
Jackson, Annette M., Sai Kanaparthi, Bryna E. Burrell, Donna P. Lucas, Renato M. Vega, Anthony J. Demetris, and Sandy Feng. “IgG4 donor-specific HLA antibody profile is associated with subclinical rejection in stable pediatric liver recipients.Am J Transplant 20, no. 2 (February 2020): 513–24. https://doi.org/10.1111/ajt.15621.
Jackson AM, Kanaparthi S, Burrell BE, Lucas DP, Vega RM, Demetris AJ, et al. IgG4 donor-specific HLA antibody profile is associated with subclinical rejection in stable pediatric liver recipients. Am J Transplant. 2020 Feb;20(2):513–24.
Jackson, Annette M., et al. “IgG4 donor-specific HLA antibody profile is associated with subclinical rejection in stable pediatric liver recipients.Am J Transplant, vol. 20, no. 2, Feb. 2020, pp. 513–24. Pubmed, doi:10.1111/ajt.15621.
Jackson AM, Kanaparthi S, Burrell BE, Lucas DP, Vega RM, Demetris AJ, Feng S. IgG4 donor-specific HLA antibody profile is associated with subclinical rejection in stable pediatric liver recipients. Am J Transplant. 2020 Feb;20(2):513–524.
Journal cover image

Published In

Am J Transplant

DOI

EISSN

1600-6143

Publication Date

February 2020

Volume

20

Issue

2

Start / End Page

513 / 524

Location

United States

Related Subject Headings

  • Tissue Donors
  • Surgery
  • Reproducibility of Results
  • Prospective Studies
  • Male
  • Liver Transplantation
  • Isoantibodies
  • Immunosuppressive Agents
  • Immunoglobulin G
  • Humans