Early Intervention in Living Kidney Transplantation Based on Dynamic Monitoring of Donor Specific Antibodies.

Chen Y, Li LY, Lou XY, Wang H, Zhang L, Zhu YH.

Clinical Transplants 2014, Chapter 25

Abstract

This study aims to analyze the clinical application of HLA donor specific antibodies (DSA) detected by Luminex single antigen beads and to discuss the impact of early intervention on renal function in DSA positive kidney transplant patients. In 64 cases of living-related renal transplantation, DSA was detected using Luminex single antigen bead assays before and after transplantation. The positive recipients were given intravenous immunoglobulin (IVIG) and increased doses of mycophenolate mofetil (MMF). The relationship between DSA and renal function was analyzed. In all transplant recipients, DSA was negative prior to transplantation. Ten DSA positive recipients were found after HLA mismatched transplantations. With intervention, two DSA positive recipients became DSA negative. In six cases, the patients' DSA intensity decreased more than 50%. In the remaining two cases, DSA intensity did not significantly decline, and within 3-6 months, antibody-mediated rejection (AMR) appeared and renal function was impaired. From our research, we conclude that dynamic monitoring of DSA using Luminex single antigen beads may help predict future changes in renal function. In addition, early application of IVIG and increasing doses of MMF can reduce the incidence of AMR.