Correlation between human leukocyte antigen antibody production and serum creatinine in patients receiving sirolimus monotherapy after Campath-1H induction

Junchao Cai, Paul I. Terasaki, Debra D. Bloom, Jose R. Torrealba, Andreas Friedl, Hans W. Sollinger, Stuart J. Knechtle

Research output: Contribution to journalArticle

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Abstract

Background. In this study, we determined whether Campath-1H induction followed by sirolimus monotherapy inhibited alloantibody production in renal transplantation. Second, we evaluated the correlation between human leukocyte antigen (HLA) antibody production and serum creatinine levels. Methods. Sera were taken 1 to 24 months after transplantation from 24 patients treated with Campath-1H and sirolimus and tested for serum creatinine and HLA-specific antibody by using flow cytometry and enzyme-linked immunosorbent assay. Results. Ten (42%) of the 24 patients treated with Campath-1H and sirolimus produced HLA antibodies. Six of these 10 developed both donor-specific antibodies (DSAs) and non-donor-specific antibodies (NDSAs), whereas only NDSAs were detected in the other four patients. In patients with biopsy-diagnosed humoral rejection (C4d+), serum levels of both DSA and NDSA significantly correlated with patient serum creatinine levels. Rejection treatment successfully reduced both DSAs and NDSAs and reversed humoral rejection. Conclusions. The numeric relationship between serum creatinine and DSA levels suggests a causal relationship between alloantibody and transplant rejection.

Original languageEnglish (US)
Pages (from-to)919-924
Number of pages6
JournalTransplantation
Volume78
Issue number6
DOIs
StatePublished - Sep 27 2004

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Sirolimus
HLA Antigens
Antibody Formation
Creatinine
Antibodies
Serum
Tissue Donors
Isoantibodies
alemtuzumab
Graft Rejection
Kidney Transplantation
Flow Cytometry
Transplantation
Enzyme-Linked Immunosorbent Assay
Biopsy

ASJC Scopus subject areas

  • Transplantation
  • Immunology

Cite this

Correlation between human leukocyte antigen antibody production and serum creatinine in patients receiving sirolimus monotherapy after Campath-1H induction. / Cai, Junchao; Terasaki, Paul I.; Bloom, Debra D.; Torrealba, Jose R.; Friedl, Andreas; Sollinger, Hans W.; Knechtle, Stuart J.

In: Transplantation, Vol. 78, No. 6, 27.09.2004, p. 919-924.

Research output: Contribution to journalArticle

Cai, Junchao ; Terasaki, Paul I. ; Bloom, Debra D. ; Torrealba, Jose R. ; Friedl, Andreas ; Sollinger, Hans W. ; Knechtle, Stuart J. / Correlation between human leukocyte antigen antibody production and serum creatinine in patients receiving sirolimus monotherapy after Campath-1H induction. In: Transplantation. 2004 ; Vol. 78, No. 6. pp. 919-924.
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AU - Friedl, Andreas

AU - Sollinger, Hans W.

AU - Knechtle, Stuart J.

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N2 - Background. In this study, we determined whether Campath-1H induction followed by sirolimus monotherapy inhibited alloantibody production in renal transplantation. Second, we evaluated the correlation between human leukocyte antigen (HLA) antibody production and serum creatinine levels. Methods. Sera were taken 1 to 24 months after transplantation from 24 patients treated with Campath-1H and sirolimus and tested for serum creatinine and HLA-specific antibody by using flow cytometry and enzyme-linked immunosorbent assay. Results. Ten (42%) of the 24 patients treated with Campath-1H and sirolimus produced HLA antibodies. Six of these 10 developed both donor-specific antibodies (DSAs) and non-donor-specific antibodies (NDSAs), whereas only NDSAs were detected in the other four patients. In patients with biopsy-diagnosed humoral rejection (C4d+), serum levels of both DSA and NDSA significantly correlated with patient serum creatinine levels. Rejection treatment successfully reduced both DSAs and NDSAs and reversed humoral rejection. Conclusions. The numeric relationship between serum creatinine and DSA levels suggests a causal relationship between alloantibody and transplant rejection.

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