Marilena Gregorini1, Massimo Cardillo2, Eleonora Francesca Pattonieri1, Angela Nocco3, Annalisa Innocente3, Carmelo Libetta1, Vincenzo Sepe1, Anna Lia Asti1*, Maria Antonietta Grignano1 and Teresa Rampino1
1Department of Internal Medicine and Therapeutics and Unit of Nephrology, Dialysis and Transplantation, Fondazione IRCCS Policlinico San Matteo, University of Pavia, Italy 2Italian National Transplantation Center, Italian National Institute of Health, Italy 3Transplant Immunology Laboratory, UOC Coordinamento Trapianti IRCCS Ospedale Maggiore Policlinico, ItalyFulltext PDF
We report a case of accelerated humoral rejection in a woman who received a second renal transplant after desensitization. Pre-transplant T-lymphocyte complement -dependent-cytotoxicity crossmatch was negative. A primary graft non-function occurred. The graft biopsy showed humoral rejection. Luminex test performed on kidney biopsy eluate, showed donor specific anti HLA-DP antibodies without other humoral activity. HLA-DP antibody typing is often not hindering for organ allocation, because it is believed that donor HLA-DP sensitization does not preclude the transplantation. This report demonstrates that anti-DP DSA can be associated with graft failure, their absence in serum recipient at the time of acute kidney injury must not induce in mistake. Donor HLA-DP typing in sensitized patients should always be considered with attention before allocation organs. Luminex test applied to eluate of graft biopsy can be considered a new method to identify the antibodies responsible of a rejection.
Gregorini M, Cardillo M, Pattonieri EF, Nocco A, Innocente A, Libetta C, et al. Accelerated Acute Antibody–Mediated Kidney Rejection by Anti-HLA-DP Antibody Detected in Biopsy Eluate: A Case Report. Ann Transplant Res. 2022;3(1):1016..