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Complement‐dependent cytotoxicity or flow cytometric lymphocyte crossmatch (LXM) tests may fail to detect clinically significant antibodies (Abs) against non‐human leukocyte antigen (HLA). A flow cytometric endothelial precursor cell crossmatch (EPCXM) test (XM‐ONE®) is available for detection of Abs against donor endothelial precursor cells (EPCs). We showed that lymphocytes co‐purified with EPCs...
With the introduction of sensitive antibody detection techniques, effective antibody elimination devices, therapeutic agents, such as bortezomib and eculizumab, and new concepts, such as Heidelberg algorithm, kidney paired exchange, and acceptable mismatch programs, several effective options are now available for the management of highly sensitized kidney transplant patients. However, as the number...
The influence of cytokine gene polymorphisms on transplanted kidney outcome is not well understood. The aim of this one‐centre study was to analyse the association between tumour necrosis factor‐α (TNF‐α), interleukin‐6 (IL‐6), IL‐10, interferon‐γ (IFN‐γ) and transforming growth factor‐β1 (TGF‐β1) genotypes and the incidence of delayed graft function (DGF), acute rejection (AR) and 5‐year kidney graft...
Pre‐formed and de novo anti‐human leukocyte antigen (HLA) antibodies induce antibody‐mediated rejection and are also involved in mechanisms leading to chronic graft nephropathy. The detection of anti‐HLA antibodies by solid‐phase assay (SPA) has revolutionized the management of immunized patients before and after kidney transplantation. Characterized by high sensitivity and specificity, the clinical...
One of the major tasks of human leukocyte antigen (HLA) laboratories is the pretransplant determination of unacceptable HLA antigen mismatches (UAM) in organ transplant recipients. HLA antigen specificities are determined against which the patient has circulating alloantibodies that are expected to harm the transplanted organ. Using the information on UAM, negative crossmatch (XM) prediction or ‘virtual...
In this study we have evaluated an alternative 96‐well format flow cytometry based (FCtox) method which enable simultaneous detection of cytotoxicity and human leukocyte antigen (HLA) antibody binding. Comparable results were obtained in side‐by‐side comparisons with conventional complement‐dependent cytotoxicity (CDC) and flow cytometric crossmatch (FCXM) in terms of sensitivity and specificity....
Inclusion of human leukocyte antigen (HLA) matching in donor kidney allocation schemes has been based solely on its association with graft survival. Other long‐term effects associated with HLA incompatibility are largely unexplored. Data from deceased donor kidney transplants reported to the Collaborative Transplant Study have been analyzed to assess the relation between HLA mismatching and clinical...
An increased understanding of the mechanisms by which the immune system mounts a response to transplanted organs has allowed the development of immunosuppressive regimens that limit acute T‐cell‐mediated rejection (TCMR). However, the treatment of acute and chronic antibody‐mediated rejection (ABMR) in kidney transplants remains sub‐optimal. The occurrence and severity of antibody‐mediated graft pathology...
One of the major tasks of histocompatibility and immunogenetics laboratories is the pretransplant determination of unacceptable antigen mismatches (UAM) in kidney transplant recipients. In this procedure, human leucocyte antigen (HLA) specificities are defined against which the patient has circulating alloantibodies that are expected to harm the transplanted organ. Using the information on UAM and...
The impact of patient's biological differences in waiting time for kidney transplantation is well known and has been a subject of extensive debate and struggle in transplantation community. Our purpose was to evaluate patient's access to kidney transplantation in Portugal, regarding their degree of allosensitization and blood type. A retrospective cohort study including 1020 candidates for kidney...
Background
Highly immunized patients are a challenge for organ transplantation programs. One way of increasing the likelihood of transplantation in this group of patients is to expand the possible donations by defining acceptable HLA mismatches. In the Scandiatransplant Acceptable Mismatch Program (STAMP), a de‐centralized approach has been implemented in 2009.
Aims
The program has been improved...
FoxP3 and Vav1 are known to be involved in the development of regulatory T cells. Two polymorphic sites in the FoxP3 promoter (rs3761548 and a (GT)n‐dinucleotide repeat) and 2 single nucleotide polymorphisms in intron 1 of the Vav1 gene (rs2546133 and rs2617822) have been shown to correlate with gene expression levels. We investigated a potential impact of FoxP3 and Vav1 genetic variants on kidney...
The role of de novo donor‐specific anti‐human leukocyte antigen (anti‐HLA) antibodies (dnDSA) within the pathways leading to graft failure remains not fully understood. We investigated 56 patients who were transplanted between 2002 and 2014 with kidney graft failure (cases), for a possible association of development of dnDSA with graft failure. The 56 patients with failed transplants were matched...
The reliability of a scientific work depends on the accuracy of the analysis. Scientific publications in the field of kidney transplantation still contain methodical errors that may lead to wrong conclusions and result in severe consequences for the patients. Using the data from the Collaborative Transplant Study, we are presenting in this study six examples of the erroneous usage of statistical methods...
Calculated panel reactive antibodies (CPRA) is a sensitization measure used to classify and prioritize transplant candidates in different kidney transplant allocation systems. CPRA is based on identification of HLA unacceptable on potential organ donors making a transplant candidate ineligible for transplantation. Here, we present a CPRA online estimator based on HLA allelic and haplotypic frequencies...
Kidney transplant recipient killer cell immunoglobulin‐like receptors (KIR) genotype and HLA‐C status of their donors have been separately associated with BK virus‐associated nephropathy (BKVAN) and BK virus infection. Our aim was to determine whether different combinations of recipients KIR genes and donor HLA‐C ligands influence the risk of BKVAN. Retrospective case‐control study included 23 recipients...
Monitoring of donor‐specific HLA antibodies (DSA) has become part of the clinical routine in kidney transplantation. This paper gives a brief overview on data from the Collaborative Transplant Study (CTS) and the Heidelberg Transplant Center on the clinical relevance of post‐transplant DSA monitoring in patients undergoing renal transplantation. The obtained findings underline the importance of DSA...
Kidney transplantation is the best treatment option for patients with end‐stage renal disease (ESRD). The waiting time for a deceased donor kidney in the Netherlands is approximately 3 years. Mortality among patients on the waiting list is high. The aim of the PROCARE consortium (PROfiling Consortium on Antibody Repertoire and Effector functions) was to decrease the waiting time by providing a matching...
The new kidney allocation system in the United States has improved deceased donor transplant rates among candidates with high calculated panel reactive antibodies (CPRAs). Probability analysis predicts a very low transplant rate as the CPRA approaches 100%. This study sought to determine if the rate of deceased donor kidney transplant based on the actual CPRA in the cohort of 100% qualifying candidates...
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