Lymphocytotoxic antibodies and anti-HLA antibodies in kidney transplants with urologic obstruction

• Type: Article in International Scientific Journal
• Date: 2001

Authors

Teixeira, JF (Author) Other; Monteiro, MS (Author) Other; José Oliveira (Author) FMUP; Osorio, E (Author) Other; Almeida, L (Author) Other; Pestana M (Author) FMUP; Mendes, AA (Author) Other

Journal

Title: European Journal of Immunogenetics

Vol. 28

Final page: 254

ISSN: 0960-7420

Publisher: Blackwell

Indexing

Scopus - 0 Citations

Other information

Authenticus ID: P-008-PXN

Abstract (EN): Lymphocytotoxic antibodies (Ab) and anti-HLA Ab pre-kidney transplantation (TX) carry an enhanced risk of acute rejection. When these Ab are present post-TX they associate with both previous acute rejection episodes and future development of chronic rejection culminating into a lower graft survival. The synthesis of these Ab may be promoted by other less specific stimuli as infections and other inflammatory states. Urologic obstruction is followed by a inflammatory reaction with infiltration of the kidney by monocytemacrophages and lymphocytes. Urologic problems post-TX are a common complication. We studied the influence of urologic obstruction upon the synthesis of lymphocytotoxic and anti-HLA Ab. One hundred and forty-eight TX were studied. All were recipients of cadaver kidney TX and were treated with classical triple therapy. They were divided into two groups: Group I, n=1 18, were stable TX, both rejection-free and without urologic complications. Group II, n=30, were rejection-free TX but with urologic obstruction diagnosed both by a pelvic-ureteral dilatation with a concomitant small to moderate rise in serum creatinine. The obstruction was either caused by a lymphocele or a ureter stricture. Lymphocytotoxic Ab and anti-HLA Ab were measured at the end of first month post-TX in both groups, in group II at a time they were suffering obstruction. Lymphocytotoxic antibodies were measured by conventional CDC methodology and anti-HLA Ab were determined by ELISA (LAT-One Lambda). We found no significant differences on comparing both groups for sex, age, HLA matching, lymphocytotoxic and anti-HLA Ab pre-TX, pre- and post-TX blood transfusions, infectious episodes post-TX. In group I, 8/118 were positive for CDC Ab while in group II 11/30 were positive (P<0.001). As for anti-HLA Ab, 9/118 from I were positive while in II 11/30 were positive (P<0.001). For CDC, obstruction carried an odds ratio = 7.9 while for anti-HLA, obstruction was associated with an odds ratio = 8.0. We conclude that urologic obstruction post-TX is associated with a significant upregulated synthesis of both lymphocytotoxic Ab and anti-HLA Ab. We speculate that in some cases this Ab production may be triggered by inflammatory reaction caused by obstruction while in other cases it could have been brought about by an expression of hidden antigens both HLA specific and graft-tissue specific. In any case these Ab may precipitate the development of a chronic rejection process which could explain the finding of fibrotic changes in some of these previously obstructed kidneys. © 2001 Blackwell Science Ltd.

Language: English

Type (Professor's evaluation): Scientific