The role of donor-specifi c anti-HLA antibodies in the development of humoral rejection
https://doi.org/10.23873/2074-0506-2018-10-2-118-125
Abstract
Humoral rejection belongs to severe complications of the post-transplant period. Mechanisms of humoral rejection proceed through antibody formation. Donor specific anti-HLA antibodies (anti-HLA DSAs) damage transplant tissues by activating the complement system, leading to the dysfunction and loss of the transplanted organ. This article describes the clinical case of humoral rejection development with the identification of anti-HLA DSAs, their impact on the risk of coronary artery disease of the transplanted heart, and the graft loss.
About the Authors
L. K. Tkhatl'
Research Institute – Regional Clinical Hospital № 1. n.a. prof. S.V. Ochapovsky; Kuban State Medical University
Russian Federation
Russian Federation
Laura K. Tkhatl' - Cardiologist, Cardiology Department № 3 at RI – RCH № 1. n.a. Prof. S.V. Ochapovsky.
167, 1 May str., Krasnodar 350086; 4, Sedin str., Krasnodar 350063
I. A. Pashkova
Research Institute – Regional Clinical Hospital № 1. n.a. prof. S.V. Ochapovsky; Kuban State Medical University
Russian Federation
Russian Federation
167, 1 May str., Krasnodar 350086; 4, Sedin str., Krasnodar 350063
E. D. Kosmacheva
Research Institute – Regional Clinical Hospital № 1. n.a. prof. S.V. Ochapovsky; Kuban State Medical University
Russian Federation
Russian Federation
167, 1 May str., Krasnodar 350086; 4, Sedin str., Krasnodar 350063
References
1. Yancy C.W., Jessup M., Bozkurt B., et al. 2013 ACCF/AHA guideline for the management of heart failure: a report of the American College of Cardiology Foundation/American Heart Association Task Force on Practice Guidelines. Circulation. 2013;128(16):e240–327. PMID:23741058 DOI:10.1161/CIR.0b013e31829e8776
2. Gautier S.V., Shevchenko A.O., KormerA.Ya., et al. Three decades of heart transplantation in the Shumakov center: long-term outcomes. Russian Journal of Transplantology and Artificial Organs. 2015;17(2):70–73. (In Russian). DOI:10.15825/1995-1191-2015-2-70-73
3. Gautier S.V., ed. Transplantology: results and perspectives. Volume VIII. 2016 year. Tver': Triada Publ., 2017. 367 p. (In Russian).
4. Berkos A.S., Nikolaev G.V. Pathways of recognition of foreign antigens in the adaptive immune response to allogeneic organ transplantation. Russian Journal of Transplantology and Artificial Organs. 2015;17(4):104–117. (In Russian). DOI:10.15825/1995-1191-2015-4-104-117
5. Taylor D.O., Yowell R.L., Kfoury A.G. Allograft coronary artery disease: clinical correlations with circulation anti-HLA antibodies and the immunopathologic pattern of vascular rejection. J Heart Lung Transplant. 2000;19(6):518–521. PMID:10867330
6. Beletskaya L.V., Baranova F.S., Kupriyanova A.G., et al.The complement C4d component is one of the markers of rejection of the humoral type. Russian Journal of Transplantology and Artificial Organs. 2003;(4):72–77. (In Russian).
7. Sushkov A.I., Moysyuk Ya.G. Intravenous immunoglobulin administration for desensitization before renal transplantation and managing antibodymediated rejection. Russian Journal of Transplantology and Artificial Organs. 2011;13(2):110–121. (In Russian). DOI:10.15825/1995-1191-2011-2-110-121
8. Picascia A., Grimaldi V., Casamassimi A., De Pascale M.R., et al. Human leukocyte antigens and alloimmunization in heart transplantation: an open debate. J Cardiovasc Transl Res. 2014;7:664–675. PMID:25190542 DOI:10.1007/s12265014-9587-z
9. O’Connor M.J., Keeshan B.C., Lin K.Y., Monos D., et al. Changes in the methodology of pre-heart transplant human leukocyte antibody assessment: an analysis of the United Network for Organ Sharing database. Clin Transplant. 2015;29(9):842–850. PMID:26172275 DOI:10.1111/ctr.12590
10. Colvin M.M., Cook J.L., Chang P., et al. Antibody-mediated rejection in cardiac transplantation: emerging knowled ge in diagnosis and management: a scientific statement from the American Heart Association. Circulation. 2015;131(18):1608–1639. PMID:25838326 DOI:10.1161/CIR.0000000000000093
11. Kobashigawa J., Crespo-Leiro M.G., Ensminger S.M., et al. Report from a consensus conference on antibody-mediated rejection in heart transplantation. J Heart Lung Transplant. 2011;(30):252– 269. PMID:21300295 DOI:10.1016/j.healun.2010.11.003
12. Berry G.J., Angelini A., Burke M.M., et al. The ISHLT working formulation for pathologic diagnosis of antibody-mediated rejection in heart transplantation: evolution and current status (2005–2011). J Heart Lung Transplant. 2011;30(6):601– 611. PMID:21555100 DOI:10.1016/j.healun.2011.02.015
13. Stehlik J., Edwards L.B., Kucheryavaya A.Y., et al. The Registry of the International Society for Heart and Lung Transplantation: Twenty-eighth Adult Heart Transplant Report–2011. J Heart Lung Transplant. 2011;30(10):1078– 1094. PMID:21962016 DOI:10.1016/j.healun.2011.08.003
14. Smith J.D., Danskine A.J., Laylor R.M., et al. The effect of panel reactive antibodies and the donor specific crossmatch on graft survival after heart and heartlung transplantation. Transpl Immunol. 1993;1(1):60–65. PMID:8081763
15. Soleimani B., Lechler R.I., Hornick P.I., George A.J. Role of alloantibodies in the pathogenesis of graft arteriosclerosis in cardiac transplantation. Am J Transplant. 2006;6(8):1781–1785. PMID:16771817 DOI:10.1111/j.16006143.2006.01401.x
16. Smith J.D., Banner N., Hamour M., et al. De novo donor HLA specific antibodies after heart transplantation are an independent predictor of poor patient surv ival. Am J Transplant. 2011;11(2):312–319. PMID:21219570 DOI:10.1111/j.1600-6143.2010.03383.x
17. Kaneku H. Annual literature review of donor-specific HLA antibodies after organ transplantation. Clin Transpl. 2011:311–318. PMID:22755424
18. Angaswamy N., Tiriveedhi V., Sarma N.J., et al. Interplay between immune responses to HLA and nonHLA self-antigens in allograft rejection. Hum Immunol. 2013;74(11):1478– 1485. PMID:23876679 DOI:10.1016/j. humimm.2013.07.002
19. Gautier S.V., ed., et al. Russian Transplant Society. Heart Transplantation: National Clinical Recommendations. Moscow, 2013. 92 p. Available at: http://transpl.ru/images/cms/data/pdf/nacional_nye_klinicheskie_rekomendacii_po_transplantacii_serdca.pdf(In Russian).
20. Frank R., Molina M.R., Goldberg L.R., et al. Circulating donor-specific antihuman leukocyte antigen antibodies and complement C4d deposition are associated with the development of cardiac allograft vasculopathy. Am J Clin Pathol. 2014;142(6):809–815. PMID:25389335, DOI:10.1309/AJCPTLBEU5BQ8SHN
21. Russian Transplant Society. Heart transplantation and mechanical support of blood circulation: methodical guidelines. Moscow, 2016. 115 p. Available at: http://democenter.compilesoft.ru/clinrecalg6/Files/recomend/%D0%9C%D0%A035.PDF (In Russian).
22. Husain A.N., Mirza K.M., Fedson S.E. Routine C4d immunohistochemistry in cardic allografts: Long-term outcomes. J Heart Lung Transplant. 2017;36(12):1329–1335. PMID:28988608 DOI:10.1016/j.healun.2017.09.004
Review
For citations:
Tkhatl' L.K., Pashkova I.A., Kosmacheva E.D. The role of donor-specifi c anti-HLA antibodies in the development of humoral rejection. Transplantologiya. The Russian Journal of Transplantation. 2018;10(2):118-125. https://doi.org/10.23873/2074-0506-2018-10-2-118-125
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