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Akım Sitometrisi ile Böbrek Nakli Sonrası Vericiye Özgü Antikorların Monitorizasyonu

Flow Cytometry Monitoring of Donor Specifi c Antibodies after Kidney Transplantation

Journal Name:

  • Türk Nefroloji, Diyaliz ve Transplantasyon Dergisi

Publication Year:

  • 2010
DOI: 
doi: 10.5262/tndt.2010.1002.64

Key Words:

Keywords (Original Language):

Author NameUniversity of AuthorFaculty of Author
Abstract (2. Language): 
OBJECTIVE: In this study, we purpose that the screening of posttransplant donor spesifi c antibodies (DSA) and target of these antibodies by fl ow-cytometry. We also try to investigate that the relationship with the DSA’s and the graft survival. MATERIAL and METHODS: Fifty renal transplant patients and their related donors were included to study. Serum samples were taken 1., 7.,14. days and 1., 3., 6 and 12. posttransplant months. T and B cell fl ow cytometric cross-match tests were performed with the donor derived fresh cells. RESULTS: We determined as positive FCXM results of postransplant 1., 7., 14. days as 16%, and 1., 6., 9. and 12. months 18%, 14%, 12% and 12% respectively. While 5 patients results are positive in whole study time, 6 patients results were positive different test days. Two of fi ve patients who had whole study days FCXM positive lost their allografts due to acute rejection episodes in posttransplant secod and third day. Chronic allograft dysfuntion was occured in three of 6 patients who had FCXM positive (B cell FCXM positive) in the different day. Two patients lost their grafts during the study period. Graft survival was found 96% and 96% in 6 and 12 months respectively. There was a relationship between the test days creatinine levels and FCXM results. CONCLUSION: As a result; while positive results of B and T cell FCXM in whole study days are related with the acute rejection and graft survival but there is no relationship with chronic rejection. It was also found that no relationship between the only T cell positive FCXM and acute rejection, graft survival and chronic rejection. In the fi rst posttransplant month, the relationship between positive B cell FCXM tests and chronic rejection were found statistically signifi cant. It is shown that the posttransplant B and T cell FCXM and fi rst month B cell FCXM tests are predictive for acute rejection, graft survival and chronic rejection respectively. Permanent and intermittent FCXM positivity were not found related with acute rejection and graft survival. The creatinine levels of patients with FCXM positivity were found to be higher than the patients with FCXM negative.
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Abstract (Original Language): 
AMAÇ: Bu çalışmada, akım sitometrisi ile çaprazlama (ASCM) yöntemi ile saptanan vericiye özgü antikorların oluşumu, bu antikorların hedef hücresi ve devamlılığı ile rejeksiyon, graft sağkalımı arasındaki ilişkinin değerlendirilmesi amaçlanmıştır. GEREÇ ve YÖNTEMLER: Çalışmaya böbrek nakli olmuş 50 hasta ve onların akraba vericileri dahil edilmiştir. Nakil sonrası 1., 7., 14. gün ve 1., 3., 6. ve 12. aylarda hastalardan serum elde edilerek vericilerin taze hücreleri ile T ve B ASCM uygulanmıştır. BULGULAR: Nakil sonrası yapılan test sonuçları değerlendirildiğinde, 1., 7. ve 14. gün testlerinin, 8 (%16)’inin, 1. ay 9 (%18)’unun, 3. ay 7 (%14)’sinin, 6. ay ve 12. ay 6 (%12)’sının pozitif olduğu saptanmıştır. Hastalardan 5’inin tüm çalışma süresince ASCM sonuçları (+) iken, 6 hastanın farklı test günlerinde sonuçlarının (+) olduğu saptanmıştır. Tüm çalışma süresince ASCM sonuçları (+) olan 5 hastadan 2’si (her ikisinde de tüm çalışma günlerinde T, B +) akut rejeksiyon sonucu böbreklerini kaybetmişler. Farklı test günlerinde (+) olan 6 hastanın 3’ü (3 hastanın sonucu da B ASCM +) kronik rejeksiyon nedeniyle takip edilmektedir. Çalışma süresince 2 hasta graftlarını kaybetmiştir. Altı aylık ve 1 yıllık graft sağkalımı %96 olarak saptanmıştır. Ayrıca, hastaların test günlerindeki kreatininin düzeyleri ile ASCM (+) ve (-) sonuçlar arasında ilişki bulunmuştur. SONUÇ: Nakil sonrasında ASCM testi yaptığımız tüm günlerde elde edilen test sonuçlarını hedef hücrelerin pozitifl iğine göre değerlendirdiğimizde; T,B ASCM (+) sonuçların tüm çalışma günlerinde, akut rejeksiyon ve graft sağkalımı, ile ilişkisi istatistiksel açıdan anlamlı iken, bu kronik rejeksiyon ile anlamsız bulunmuştur. Nakil sonrası ilk 1 ay içindeki B ASCM (+) sonuçların ise, kronik rejeksiyon ile ilişkisi istatistiksel açıdan anlamlıdır. Nakil sonrası tüm test günlerinde saptanan T, B ASCM (+) sonuçların akut rejeksiyon ve graft sağkalımı konusunda, ilk 1 ay içindeki tüm B ASCM (+) sonuçların ise, kronik rejeksiyon konusunda kliniğe ışık tutabileceği görülmektedir. ASCM (+) olan hastaların devamlı ve aralıklı test günlerindeki pozitifl ik ile rejeksiyon ve graft sağkalımı arasındaki ilişki istatistiksel açıdan anlamsız bulunmuştur. ASCM (+) olan hastaların kreatinin düzeylerinin ortalaması ASCM (-) olan hastalardan daha yüksek olarak bulunmuştur.
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  • Turkish

REFERENCES

References: 

1. Bray RA: Flow cytometry cross matching for solid organ
transplantation, Methods in Cell Biology 1994; 41:103-119
2. De Carvalho Bittencourt M, Saint-Hillier Y, Chabod J, Dupont
I, Chalopin JM, Hervé P, Tiberghien P: B-cell fl ow-cytometry
crossmatch: Infl uence in renal transplantation. Transplant Proc
1997; 29 (1-2):1456-1457
3. Piazza A, Poggi E, Borrelli L, Valeri M, Buonomo O, Servetti S,
Adorno D, Casciani CU: Relevance of posttransplant HLA class
I and class II antibodies on renal graft outcome. Transplant Proc
2001; 33(1-2):478-480
4. Piazza A, Borrelli L, Buonomo O, Pisani F, Valeri M, Torlone N,
Felici A, Monaco PI, Adorno D, Casciani CU: Flow cytometry
crossmatch and kidney graft outcome. Transplant Proc 1999;
31(1-2):314-316
5. Leffell MS, Fallin MD, Hildebrand WH, Cavett JW, Iglehart BA,
Zachary AA: HLA alleles and haplotypes among the Lakota Sioux:
Report of the ASHI minority workshops, part III. Hum Immunol
2004; 65(1):78-89. of Antibodies By HLA Class Specifi city. Human
Immunology 2004; 65:Suppl (1); 2-4
6. Michalska K, Korczak-Kowalska G, Podobińska I, Durlik M,
Wyzgał J, Lewandowska D, Wierzbicki P, Kłosowska D, Chmura A,
Rowiński W, Nowaczyk M, Górski A: Flow cytometry crossmatch
in living donor renal transplantation. Transplant Proc 2002; 34(2):
689-690
7. Akalin E, Ames S, Sehgal V, Fotino M, Daly L, Murphy B, Bromberg
JS: Intravenous immunoglobulin and thymoglobulin facilitate
kidney transplantation in complement dependent cytotoxicity B cell
and fl ow cytometry cross-match-positive patients. Transplantation
2003; 76 (10):1444-1447
8. Katayama A, Kobayashi T, Uchida K, Goto N, Matsuoka S, Sato
T, Haba T, Tominaga Y, Kohara S, Kamura H, Liu D, Yokoyama I,
Oikawa T, Takeda A, Morozumi K, Takagi H, Nakao A: Benefi cial
effect of antibody removal and enhanced immunosuppression in
fl ow cytometry cross match-positive and ABO-incompatible renal
transplantation. Transplant Proc 2002; 34(7):2771-2772
9. Scornik JC: Detection of alloantibodies by fl ow cytometry: relevance
to clinical transplantation cytometry. Communications in Clinical
Cytometry 1995; 22:259-263
10. Hayry P, Alatalo S, Myllarniemi M, Raisanen-Sokolowski A,
Lemström K: Myllarniemi. Cellular and molecular biology of chronic
rejection. Transplant Proc 1995 (27); 1: 71-74
11. Piazza A, Adorno D, Poggi E, Borrelli L, Buonomo O, Pisani F, Valeri
M, Torlone N, Camplone C, Monaco PI, Fraboni D, Casciani CU:
Flow cytometry crossmatch: A sensitive technique for assessment
of acute rejection in renal transplantation. Transplant Proc 1998;
30(5):1769-1771
12. Fernández-Fresnedo G, Pastor JM, López-Hoyos M, Ruiz JC,
Zubimendi JA, Gonzalez-Cotorruelo J, Rodrigo E, De Francisco AL,
Arias M: Relationship of donor-specifi c class-I anti-HLA antibodies
detected by ELISA after kidney transplantation on the development
of acute rejection and graft survival. Nephrol Dial Transplant 2003;
18(5):990-995
13. Zhang Q, Liang LW, Gjertson DW, Lassman C, Wilkinson AH,
Kendrick E, Pham P, Danovıtch GM.et al, Ablin GH, Reed EF:
Develpoment of posttransplant antidonor HLA antibodies is
associated with acute humoral rejection and early graft dysfunction.
Transplantation 2005; 79 (5):591-598
14. Müller-Steinhardt M, Fricke L, Kirchner H, Hoyer J, Klüter H:
Monitoring of anti-HLA class I and II antibodies by fl ow cytometry
in patients after fi rst cadaveric kidney transplantation. Clin
Transplant 2000; 14(1):85-89
15. Kaufman A. De Souza Pontes LF, Queiroz, Marques MT, Sampaio
SC, De Moraes sabrino porto LC, De moraes souza ER: Analysis
of AHG-PRA and ELISA-PRA in kidney transplant patients with
acute rejection episodes. Transp Immunol 2003; 11 (2):175-178
16. Bray RA, Lebeck LL, Gebel HM: The fl owcytometric crossmatch.
Dual-color analysis of T cell and B cell reactivities. 1989; 48:834-840
17. Bray RA: Crossmatching by fl owcytometry. Clinic immunology
newsletter 1990; 10:63-68
18. Tambur AR, Klein T: Flow cytometry application in organ
transplantation. Isr Med Assoc J 2000; 2(4):310-315
19. Abbas AK, Lıchtman AH, Pober JS: Transplantation immunology,
Cellular and molecular immunology. 4th ed USA: 2000, 363-383
20. Piazza A, Poggi E, Borrelli L, Servetti S, Monaco PI, Buonomo
O, Valeri M, Torlone N, Adorno D, Casciani CU: Impact of donorspecifi
c antibodies on chronic rejection occurrence and graft loss in
renal transplantation: posttransplant analysis using fl ow cytometric
techniques. Transplantation 2001; 27;71(8):1106-1112
21. Zhang X, Reed EF: Effect of antibodies on endothelium. Am J
Transplant 2009; 9(11):2459-2465
22. Utzig MJ, Blümke M, Wolff-Vorbeck G, Lang H, Kirste G: Flow
cytometry cross-match: A method for predicting graft rejection.
Transplantation 1997; 63(4):551-554

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