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Donor-specific HLA antibodies of IgG3 subclass are associated with chronic rejection and graft loss after liver transplantation.
MedLine Citation:
PMID:  22508525     Owner:  NLM     Status:  Publisher    
Abstract/OtherAbstract:
In our previous study, 92% of patients with chronic rejection had donor-specific HLA antibodies (DSA), but surprisingly 61% of comparator patients without rejection also had DSA. We hypothesized there are differentially distributed IgG subclasses between the two groups. A modified single antigen bead assay was used to detect the presence of individual IgG subclasses against HLA in 39 chronic rejection patients and 66 comparator patients. DSA of the IgG1 subclass was the most common subclass, found in 45% of all patients, followed by IgG3 in 21%, IgG4 in 14% and IgG2 in 13%. A significantly higher frequency of patients with multiple IgG subclasses was observed in the chronic rejection group versus the comparator group (50% vs. 14%, p<0.001). Patients with normal graft function in the presence of DSA mostly have isolated IgG1, compared to patients with chronic rejection who have a combination of IgG subclasses. Patients who developed DSA of the IgG3 subclass showed an increased risk for graft loss, with a hazard ratio of 3.35 (95% confidence interval: 1.39-8.05) when compared to patients with DSA of other IgG subclasses or without DSA. Although further study is needed, determination of IgG subclass in DSA positive patients may help to identify patients with a higher risk of chronic rejection and graft loss. © 2012 American Association for the Study of Liver Diseases.
Authors:
Hugo Kaneku; Jacqueline G O'Leary; Michiko Taniguchi; Brian M Susskind; Paul I Terasaki; Göran B Klintmalm
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Publication Detail:
Type:  JOURNAL ARTICLE     Date:  2012-4-16
Journal Detail:
Title:  Liver transplantation : official publication of the American Association for the Study of Liver Diseases and the International Liver Transplantation Society     Volume:  -     ISSN:  1527-6473     ISO Abbreviation:  -     Publication Date:  2012 Apr 
Date Detail:
Created Date:  2012-4-17     Completed Date:  -     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  100909185     Medline TA:  Liver Transpl     Country:  -    
Other Details:
Languages:  ENG     Pagination:  -     Citation Subset:  -    
Copyright Information:
Copyright © 2012 American Association for the Study of Liver Diseases.
Affiliation:
University of California Los Angeles, CA, USA; Terasaki Foundation Laboratory, Los Angeles, CA, USA. hkaneku@mednet.ucla.edu.
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