Misleading de novo detection of serum anti-HLA-A3 antibodies in kidney recipients having received ATG before transplantation.

Anti-HLA antibody (Ab) monitoring is essential for the follow-up of transplant patients. However, it can be affected by drugs, especially Ab infused as a conditioning regimen for transplantation. ATG Fresenius, commonly used in this setting, is a polyclonal rabbit Ab raised against the Jurkat human T cell line (HLA-A3, 32; B7, 35).

Hyperacute rejection after lung transplantation caused by undetected low-titer anti-HLA antibodies.

Hyperacute rejection is an early complication of transplantation, caused by the presence in the recipient of pre-formed donor-directed antibodies (Ab). We report a case of fatal early graft dysfunction after lung transplantation in a female recipient with no anti-HLA Ab detected before transplantation. Further immunologic studies revealed the presence, in the pre-transplant serum, of low-titer anti-HLA Ab directed against the donor's HLA, detectable only by flow-cytometry screening for panel-reactive antibodies.

Flow cytometric evaluation of pregnancy-induced anti-HLA immunization and blood transfusion-induced reactivation.

Background: Pregnancy-induced alloimmunization (PIA) may decrease to a level that becomes undetectable by complement-dependent cytotoxicity (CDC). Nevertheless, such alloimmunization may provoke acute rejections after kidney transplantation and lead to broad-spectrum immunizations after transfusion. Flow-cytometry (FC) was used to estimate the frequency of low-level PIA and to evaluate its influence on posttransfusion alloimmunization profiles.