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Successful kidney transplantation across a positive complement-dependent cytotoxicity crossmatch by using C1q assay-directed, bortezomib-assisted desensitization: A case report.

Λεπτομέρειες βιβλιογραφικής εγγραφής
Τίτλος: Successful kidney transplantation across a positive complement-dependent cytotoxicity crossmatch by using C1q assay-directed, bortezomib-assisted desensitization: A case report.
Συνεισφορές: College of Medicine, Dept. of Internal Medicine, Juhan Lee, Borae G. Park, Hyang Sook Jeong, Youn Hee Park, Sinyoung Kim, Beom Seok Kim, Hye Jin Kim, Kyu Ha Huh, yeon Joo Jeong, Yu Seun Kim, Kim, Beom Seok, Kim, Sin Young, Kim, Yu Seun, Kim, Hye Jin, Park, Borae G, Park, Youn Hee, Jeong, H.S., Jeong, Hyeon Joo, Huh, Kyu Ha
Στοιχεία εκδότη: Lippincott Williams & Wilkins
Έτος έκδοσης: 2017
Θεματικοί όροι: Desensitization, Immunologic/methods, Graft Rejection*/immunology, Graft Rejection*/prevention & control, HLA-B Antigens/analysis, Histocompatibility Antigens/analysis, Histocompatibility Testing/methods, Humans, Kidney Failure, Chronic*/immunology, Chronic*/surgery, Kidney Transplantation*/adverse effects, Kidney Transplantation*/methods, Male, Middle Aged, Preoperative Care/methods, Treatment Outcome
Περιγραφή: RATIONALE: Human leukocyte antigen (HLA) is the major immunologic barrier in kidney transplantation (KT). Various desensitization protocols to overcome the HLA barrier have increased the opportunity for transplantation in sensitized patients. In addition, technological advances in solid-phase assays have permitted more comprehensive assessment of donor-specific antibodies. Although various desensitization therapies and immunologic techniques have been developed, the final transplantation decision is still based on the classic complement-dependent cytotoxicity (CDC) crossmatch (XM) technique. Some patients who fail to achieve negative XM have lost their transplant opportunities, even after receiving sufficient desensitization therapies. PATIENT CONCERNS: A 57-year-old male with end-stage renal disease secondary to chronic glomerulonephritis was scheduled to have a second transplant from his son, but CDC XM was positive. DIAGNOSES: Initial CDC XM (Initial T-AHG 1:32) and flow-cytometry XM were positive. Anti-HLA-B59 donor specific antibody was detected by Luminex single antigen assay. INTERVENTIONS: Herein, we report a successful case of KT across a positive CDC XM (T-AHG 1:8 at the time of transplantation) by using C1q assay-directed, bortezomib-assisted desensitization. After confirming a negative conversion in the C1q donor-specific antibody, we decided to perform KT accepting a positive AHG-CDC XM of 1:8 at the time of transplantation. OUTCOMES: The posttransplant course was uneventful and a protocol biopsy at 3 months showed no evidence of rejection. The patient had excellent graft function at 12 months posttransplant. LESSONS: The results of XM test and solid-phase assay should be interpreted in the context of the individual patient. ; open
Τύπος εγγράφου: article in journal/newspaper
Γλώσσα: English
Relation: MEDICINE; J02214; https://ir.ymlib.yonsei.ac.kr/handle/22282913/160847; T201703489; MEDICINE, Vol.96(39) : e8145, 2017; 60730
DOI: 10.1097/MD.0000000000008145
Διαθεσιμότητα: https://ir.ymlib.yonsei.ac.kr/handle/22282913/160847
https://doi.org/10.1097/MD.0000000000008145
Rights: CC BY-NC-ND 2.0 KR ; https://creativecommons.org/licenses/by-nc-nd/2.0/kr/
Αριθμός Καταχώρησης: edsbas.83CED997
Βάση Δεδομένων: BASE
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  Data: Successful kidney transplantation across a positive complement-dependent cytotoxicity crossmatch by using C1q assay-directed, bortezomib-assisted desensitization: A case report.
– Name: Author
  Label: Contributors
  Group: Au
  Data: College of Medicine<br />Dept. of Internal Medicine<br />Juhan Lee<br />Borae G. Park<br />Hyang Sook Jeong<br />Youn Hee Park<br />Sinyoung Kim<br />Beom Seok Kim<br />Hye Jin Kim<br />Kyu Ha Huh<br />yeon Joo Jeong<br />Yu Seun Kim<br />Kim, Beom Seok<br />Kim, Sin Young<br />Kim, Yu Seun<br />Kim, Hye Jin<br />Park, Borae G<br />Park, Youn Hee<br />Jeong, H.S.<br />Jeong, Hyeon Joo<br />Huh, Kyu Ha
– Name: Publisher
  Label: Publisher Information
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  Data: Lippincott Williams & Wilkins
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  Label: Publication Year
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  Data: 2017
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  Data: <searchLink fieldCode="DE" term="%22Desensitization%22">Desensitization</searchLink><br /><searchLink fieldCode="DE" term="%22Immunologic%2Fmethods%22">Immunologic/methods</searchLink><br /><searchLink fieldCode="DE" term="%22Graft+Rejection*%2Fimmunology%22">Graft Rejection*/immunology</searchLink><br /><searchLink fieldCode="DE" term="%22Graft+Rejection*%2Fprevention+%26+control%22">Graft Rejection*/prevention & control</searchLink><br /><searchLink fieldCode="DE" term="%22HLA-B+Antigens%2Fanalysis%22">HLA-B Antigens/analysis</searchLink><br /><searchLink fieldCode="DE" term="%22Histocompatibility+Antigens%2Fanalysis%22">Histocompatibility Antigens/analysis</searchLink><br /><searchLink fieldCode="DE" term="%22Histocompatibility+Testing%2Fmethods%22">Histocompatibility Testing/methods</searchLink><br /><searchLink fieldCode="DE" term="%22Humans%22">Humans</searchLink><br /><searchLink fieldCode="DE" term="%22Kidney+Failure%22">Kidney Failure</searchLink><br /><searchLink fieldCode="DE" term="%22Chronic*%2Fimmunology%22">Chronic*/immunology</searchLink><br /><searchLink fieldCode="DE" term="%22Chronic*%2Fsurgery%22">Chronic*/surgery</searchLink><br /><searchLink fieldCode="DE" term="%22Kidney+Transplantation*%2Fadverse+effects%22">Kidney Transplantation*/adverse effects</searchLink><br /><searchLink fieldCode="DE" term="%22Kidney+Transplantation*%2Fmethods%22">Kidney Transplantation*/methods</searchLink><br /><searchLink fieldCode="DE" term="%22Male%22">Male</searchLink><br /><searchLink fieldCode="DE" term="%22Middle+Aged%22">Middle Aged</searchLink><br /><searchLink fieldCode="DE" term="%22Preoperative+Care%2Fmethods%22">Preoperative Care/methods</searchLink><br /><searchLink fieldCode="DE" term="%22Treatment+Outcome%22">Treatment Outcome</searchLink>
– Name: Abstract
  Label: Description
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  Data: RATIONALE: Human leukocyte antigen (HLA) is the major immunologic barrier in kidney transplantation (KT). Various desensitization protocols to overcome the HLA barrier have increased the opportunity for transplantation in sensitized patients. In addition, technological advances in solid-phase assays have permitted more comprehensive assessment of donor-specific antibodies. Although various desensitization therapies and immunologic techniques have been developed, the final transplantation decision is still based on the classic complement-dependent cytotoxicity (CDC) crossmatch (XM) technique. Some patients who fail to achieve negative XM have lost their transplant opportunities, even after receiving sufficient desensitization therapies. PATIENT CONCERNS: A 57-year-old male with end-stage renal disease secondary to chronic glomerulonephritis was scheduled to have a second transplant from his son, but CDC XM was positive. DIAGNOSES: Initial CDC XM (Initial T-AHG 1:32) and flow-cytometry XM were positive. Anti-HLA-B59 donor specific antibody was detected by Luminex single antigen assay. INTERVENTIONS: Herein, we report a successful case of KT across a positive CDC XM (T-AHG 1:8 at the time of transplantation) by using C1q assay-directed, bortezomib-assisted desensitization. After confirming a negative conversion in the C1q donor-specific antibody, we decided to perform KT accepting a positive AHG-CDC XM of 1:8 at the time of transplantation. OUTCOMES: The posttransplant course was uneventful and a protocol biopsy at 3 months showed no evidence of rejection. The patient had excellent graft function at 12 months posttransplant. LESSONS: The results of XM test and solid-phase assay should be interpreted in the context of the individual patient. ; open
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  Data: MEDICINE; J02214; https://ir.ymlib.yonsei.ac.kr/handle/22282913/160847; T201703489; MEDICINE, Vol.96(39) : e8145, 2017; 60730
– Name: DOI
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  Data: 10.1097/MD.0000000000008145
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  Data: https://ir.ymlib.yonsei.ac.kr/handle/22282913/160847<br />https://doi.org/10.1097/MD.0000000000008145
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  Data: CC BY-NC-ND 2.0 KR ; https://creativecommons.org/licenses/by-nc-nd/2.0/kr/
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      – SubjectFull: Immunologic/methods
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