检索结果-南通市图书馆

Acute liver failure secondary to acute antibody mediated rejection after compatible liver transplant: A case report

World Journal of Hepatology 2022年第1期14卷 287-294页

作者： Todd J Robinson James B Hendele Idoia Gimferrer Nicolae Leca Scott W Biggins Jorge D Reyes Lena Sibulesky Department of Surgery Virginia MasonSeattleWA 98101United States Department of Surgery University of Washington Medical CenterSeattleWA 98195United States Bloodworks Northwest SeattleWA 98104United States Department of Nephrology University of Washington Medical CenterSeattleWA 98195United States Department of Gastroenterology and Hepatology University of Washington Medical CenterSeattleWA 98195United States

BACKGROUND The liver has traditionally been regarded as resistant to antibody-mediated rejection(AMR).AMR in liver transplants is a field in its infancy compared to kidney and lung *** our case we present a patient with alpha-1-antitrypsin disease who underwent ABO compatible liver transplant complicated by acute liver failure(ALF)with evidence of antibody mediated rejection on allograft biopsy and elevated serum donor-specific antibodies(DSA).This case highlights the need for further investigations and heightened awareness for timely *** SUMMARY A 56 year-old woman with alpha-1-antitrypsin disease underwent ABO compatible liver transplant from a deceased *** recipient MELD at the time of transplant was *** flow cytometric crossmatches were noted to be positive for T and B *** patient had an uneventful recovery *** on postoperative day 5 the patient developed fevers,elevated liver function tests,distributive shock,renal failure,and hepatic *** went into ALF with evidence of antibody mediated rejection with portal inflammation,bile duct injury,endothelitis,and extensive centrizonal necrosis,and C4d staining on allograft biopsy and elevated *** various interventions including plasmapheresis and immunomodulating therapy,she continued to *** was relisted and successfully underwent liver *** This very rare case highlights AMR as the cause of ALF following liver transplant requiring retransplantation.

关键词： Liver transplant Acute antibody mediated rejection Acute liver failure donor specific antibody Liver rejection Case report

来源：

维普期刊数据库评论

在线全文

维普期刊数据库

学校读者我要写书评

暂无评论

Impact of human leukocyte antigen matching and recipients＇ panel reactive antibodies on two-year outcome in presensitized renal allograft recipients

引用

Chinese Medical Journal 2009年第4期122卷 420-426页

作者： MENG Hui-lin JIN Xun-bo LI Xiang-tie WANG Hong-wei LV Jia-ju Minimally Invasive Urology Center Provincial Hospital Affiliated to Shandong University Jinan Shandong 250021 China Department of Urology Provincial Hospital Affiliated to Shandong University Jinan Shandong 250021 China Department of Urology General Hospital of Jinan Military Command Jinan Shandong 250031 China Transplant Center SecondHospitai Shandong university JinanShandong 250033 China2

Background Renal transplantation in sensitized candidates remains a highly significant challenge worldwide. The production of panel reactive antibody （PRA） against human leukocyte antigen （HLA） is a major risk factor in presensitized recipients. The aim of this study was to evaluate the impact of HLA matching and recipients＇ PRA on two-year outcome in presensitized renal allograft recipients. Methods We determined the percentage of panel reactivity and specificity of anti-HLA immunoglobulin （Ig） G antibodies in 73 presensitized renal allograft recipients compared with 81 unsensitized recipients （control group）. HLA genotyping of both recipients and corresponding donors was performed by PCR with sequence-specific primers （PCR-SSP）. We analyzed the factors influencing the early graft outcome （two-year rejection rates and survival rates of the grafts）, including HLA mismatching, class and degree of panel reactivity, and target antigen of donors. Results Presensitized recipients had a worse two-year outcome than unsensitized recipients （P=0.019 for rejection rate, P=0.01 for survival rate）. The difference in number of HLA-mismatched alleles with either 6-antigen matching （Ag M） standard or amino acid residue matching （Res M） standard was not significant between the rejection and non-rejection groups of presensitized recipients or between the graft survival group and graft loss group. Compared with the control group, recipients with both PRA-I and PRA-II antibodies had a significantly worse two-year outcome （P=0.001 for rejection rate, P=0.002 for survival rate）. The two-year outcomes of the peak PRA 〉50% group and its subgroup, at-transplant PRA 〉50% group, were significantly worse compared with the control group （P=0.025 and P=0.001 for rejection rate, P=0.043 and P=0.024 for survival rate）. The rejection rates of the at-transplant target antigen positive group and its subgroup, HLA-I target antigen positive group, were significantly higher than the control group （

关键词： HLA antigens panel reactive antibody kidney transplantation sensitization donor specific antibody

来源：

维普期刊数据库评论

在线全文

维普期刊数据库

学校读者我要写书评

暂无评论

Anti-human leukocyte antigens and anti-major histocompatibility complex class I-related chain A antibody expression in kidney transplantation during a four-year follow-up

引用

Chinese Medical Journal 2013年第15期126卷 2815-2820页

作者： HE Jun LI Chen YUAN Xiao-ni ZHANG Jiang-lei LI Yang WEI Xue-dong HOU Jian-quan Soochow Univ Affiliated Hosp 1 Jiangsu Inst Hematol Suzhou 215006 Jiangsu Peoples R China Soochow Univ Affiliated Hosp 1 Dept Urol Suzhou 215006 Jiangsu Peoples R China Wuxi 2 Peoples Hosp Dept Urol Wuxi 214002 Jiangsu Peoples R China

Background Humoral immunity is an important factor for long-term survival of renal allograft. Here we performed a four-year follow-up to explore the clinical significance of monitoring anti-human leukocyte antigens （HLA） and anti-major histocompatibility complex class I-related chain A （MICA） antibody expression after kidney transplantation. Methods We obtained serial serum samples from 84 kidney transplant patients over a four-year period. All patients were followed up at least 6 months after transplantation and had at least two follow-up points. Anti-HLA and anti-MICA antibody titres and serum creatinine （SCr） levels were evaluated at each follow-up. Patients were divided into 4 groups： HLA（＋） MICA（-）, HLA（-）MICA（＋）, HLA（＋）MICA（＋） and HLA（-）MICA（-）. The impact of post-transplant antibody level on kidney allograft function was evaluated. Results Antibodies were detected in 38.1% （32/84） of the renal allograft recipients. HLA, MICA and HLA＋MICA expression was observed in 18.89%, 14.44% and 5.93% of the recipients respectively. The most frequent anti-HLA and anti-MICA specific antibodies identified were All, A24, A29, A32, A33, A80; B7, B13, B37; DR17, DR12, DR18, DR52, DR53, DR1, DR4, DR9, DR51; DQ7, DQ4, DQ8, DQ2, DQ9, DQ5, DQ6 and MICA02, MICA18, MICA19, MICA07, MICA27. As the time after transplantation elapsed, more recipients developed de novo antibody expression. Total 11.91% （10/84） of the recipients had de novo antibody expression during the follow up. The average level of SCr and the percentage of recipients with abnormal allograft function were significantly higher in recipients with anti-HLA and/or anti- MICA antibody expression than those without. The appearance of anti-HLA and anti-MICA antibody expression always preceded the increase in SCr value. Conclusions Anti-HLA and anti-MICA antibody expression has predictive value for early and late allograft dysfunction. The presence of donor specific antibody is detrimental to graft function and graft survival

关键词： kidney transplantation," human leukocyte antigens," major histocompatibility complex class I-related chain A antibody graft function donor specific antibody non-donor specific antibody

来源：

维普期刊数据库评论

在线全文

维普期刊数据库

学校读者我要写书评

暂无评论

欢迎您,

建议与咨询留下您的常用邮箱和电话号码，以便我们向您反馈解决方案和替代方法

时间限定

文献类型

馆藏选择

核心期刊

语言

文献类型

帮助

文字说明：

检索规则说明：

检索范例：

分类表

所选分类

限定检索结果

文献类型

馆藏范围

日期分布

学科分类号

主题

机构

作者

语言

在线全文

在线全文

在线全文

请选择保存的检索档案：

请选择收藏分类：

通借通还

欢迎您,

建议与咨询 留下您的常用邮箱和电话号码，以便我们向您反馈解决方案和替代方法

时间限定

文献类型

馆藏选择

核心期刊

语言

文献类型

帮助

文字说明：

检索规则说明：

检索范例：

分类表

所选分类

限定检索结果

文献类型

馆藏范围

日期分布

学科分类号

主题

机构

作者

语言

在线全文

在线全文

在线全文

请选择保存的检索档案： 新增检索档案 确定 取消

请选择收藏分类： 新增自定义分类 确定 取消

通借通还

建议与咨询留下您的常用邮箱和电话号码，以便我们向您反馈解决方案和替代方法

请选择保存的检索档案：

请选择收藏分类：