You are here

Home » Content

BÖBREK NAKLİ SONRASINDA VERİCİ HLA ANTİJENLERİNE KARŞI OLUŞAN ANTİKORLARIN AKIM SİTOMETRİSİ İLE ÇAPRAZLAMA YÖNTEMİ İLE SAPTANMASI

DETECTION OF POST TRANSPLANT DONOR SPECIFIC ANTIBODIES AGAINST DONOR HLAANTIGENS BY FLOW CYTOMETRIC CROSS MATCH

Journal Name:

  • İstanbul Tıp Fakültesi Dergisi

Publication Year:

  • 2006

Key Words:

Keywords (Original Language):

Author NameUniversity of AuthorFaculty of Author
Abstract (2. Language): 
Objective: This study was designed to reveal the clinical importance of Donor Specific Antibody (DSA) formed following renal transplantation, properties of humoral response aganist the graft, graft failure, and the role of antibodies in rejection. Materials and methods: Fifty patients who had renal transplant between March 2001 and Apr›l 2004 were included in this study. T and B Flow Cytometric Cross-Match (FCCM) test was applied to patient sera obtained at the 1st, 7th,and 14th days and 1st, 3rd,6th and 12th months and fresh donor cells were used for this analysis. Results: Thirty-nine (78%) FCCM results were found to be negative, while 11 (22%) patients depicted positive results. DSAs were formed mainly in the first month (82%) while 18% after the first month. Four patients (8%) had T and B FCCM positive while 3 patients (6%) only T FCCM positive and 4 patients (8%) only B cell positive. DSA formation classified as early and late. T and B FCCM positive results correlated well with rejection. There patients depicted graft rejection (18.1%) as well, though T and / or B FCCM negative patients did not result in graft rejection. Apart from the 1st day serum creatinin levels of ≥ 2 mg/dl significantly related with rejection and T and B FCCM positivition 7th and 14th day. Conclusion: DSAevaluation with FCCM in post transplant period relates well with graft survival and quality of life of renal transplanted patients. FCCM results in the 1st post transplant month will likely to shed light to the fate of transplantation.
Bookmark/Search this post with
Abstract (Original Language): 
Amaç:Bu çal›flmada böbrek nakli sonras› oluflan Donör Spesifik Antikor (DSA)’lar›n klinik önemi, grafta karfl› oluflan humoral cevab›n karakteri, graft yetmezli¤i ve rejeksiyonda bu antikorlar›n rolünün de¤erlendirilmesi amaçlanm› flt›r. Gereç ve yöntem: Bu çal›flmaya Mart 2001 - Nisan 2004 aras›nda böbrek transplantasyonu yap›lan 50 hasta dahil edilmifltir. Elli hasta-verici çiftine T›bbi Biyoloji Anabilim Dal›’nda Ak›m Sitometrisi ile ‘’Cross Match’’- Çaprazlama (ASCM) testi uygulanm›flt›r. Nakil sonras› hastalar›n 1., 7., 14. günlere, 1., 3., 6. ve 12. aylara ait serumlar› ve vericilerin taze hücreleri ile T ve B ASCM testi yap›lm›flt›r. Bulgular: 39 hastan›n (%78) sonucu negatifken, 11 hastan›n (%22) test sonucunun pozitif oldu¤u saptanm›flt›r. DSA’lar›n %82’si ilk ay içinde, %18’i ise birinci aydan sonraki dönemde oluflmufltur. Bunlardan 4 (% 8) hastan›n test sonucu hem T, hem de B ASCM (+), 3 (% 6) hastan›n TASCM (+), 4 (% 8) hastan›n da B ASCM sonucu (+) olarak bulunmufltur. Elde edilen antikorlar, nakil sonras› erken ve geç dönemde oluflanlar olmak üzere iki gruba ayr› larak klinik sonucu de¤erlendirilmifltir. Her iki grupta da T ve/veya B ASCM (+) sonuca sahip hastalarda rejeksiyon olufltu¤u görülmüfltür. Ayr›ca hastalar graft yetmezli¤i aç›s›ndan de¤erlendirilmifl ve nakil sonras› T ve/veya B ASCM (+) olan hastalar›n %18,1’inde graft yetmezli¤i varken, T ve/veya B ASCM (-) olan hastalar›n hiçbirisinde graft yetmezli¤i görülmemifltir. Rejeksiyon ile ≥ 2 mg/dl kreatinin düzeyleri aras›ndaki ba¤lant› istatistiksel anlaml› l›k aç›s›ndan de¤erlendirildi¤inde 1. gün d›fl›ndaki tüm sonuçlar anlaml› bulunmufltur. Ayn› kreatinin düzeyinin, T ve/veya B ASCM (+)’li¤i ile aras›ndaki ba¤lant› istatistiksel anlaml›l›k aç›s›ndan de¤erlendirildi¤inde ise, 7. ve 14. günlerdeki sonuçlar anlaml› bulunmufltur. Sonuç: Nakil sonras› ASCM yöntemi ile DSA’lar›n araflt›r›lmas›n›n nakledilen böbre¤in sa¤kal›m›n›, dolay›s›yla hastan›n yaflam kalitesini etkiledi¤i düflüncesindeyiz. Özellikle nakil sonras› ilk bir ay içindeki test sonuçlar› böbre¤ in sa¤kal›m› hakk›nda klini¤i önemli ölçüde ayd›nlatacakt›r.
FULL TEXT (PDF): 
PDF icon arastirmax-bobrek-nakli-sonrasinda-verici-hla-antijenlerine-karsi-olusan-antikorlarin-akim-sitometrisi-ile-caprazlama-yontemi-ile-saptanmasi.pdf
  • 4
93-97
  • Turkish

REFERENCES

References: 

1. Christiaans MH, Overhof-de Roos R, Nieman F, van Hooff JP,
van den Berg-Loonen EM. Donor-specific antibodies after
transplantation by flow cytometry: relative change in fluorescence
ratio most sensitive risk factor for graft survival. Transplantation
1998; 15:427-433.
2. Christopher FB, Karen AB, Paul WN, Alan ML, John M, George
EP, Gilbert R, Charles FS, III. Bradley AW, Mark IA, Thomas
SH, And Nic M. Long term graft survival is improved in
cadaveric renal retransplantation by flow cytometric crossmatching.
Transplantation 1998; 66:1827-1832.
3. Crespo M, Pascual M, Tolkoff-Rubin N, Mauiyyedi S, Collins
AB, Fitzpatrick D, Farrell ML, Williams WW, Delmonico FL,
Cosimi AB, Colvin RB, Saidman SL. Acute humoral rejection
in renal allograft recipients: I. Incidence, serology and clinical
characteristics. Transplantation 2001;15:652-658.
4. Garovoy MR, Melzer JS, AScher N, Magilligan D, Ozdech M..
Clinical transplantation, In: Stites DP, Terr AI (ed), Basic and
Clinical ‹mmunology. Los Altos, California, USA, 7th ed. 1991;
pp 747-765.
5. Karpuzo¤lu T. Organ Nakli ‹mmunobiyolojisi.Karpuzo¤lu
T(çev.ed.). Böbrek Nakli El Kitab›.Öncü Bas›mevi. Ankara, Türkiye
3.bask›., 2003; sayfa17-38.
6. Kuby J. Cell mediated and humoral effector responses, In: Immunology;
New york USA 3.th ed.1997; pp 555-571.
7. 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: Asensitive technique for
assessment of acute rejection in renal transplantation. Transplant
Proc. 1998; 30:1769-1771.
8. Puig N, Pallardo LM, Villalba JV, Sanchez J, Crespo J, Rodriguez
R, Montoro JA. Donor-specific flow cytometric crossmatch
after kidney transplantation. Transplant Proc.
1995;27:2369-2370.
9. Rodrigez PC, Palacio JL, Arango L, Henao JE, Garcia LF. Detection
of allo and auto antibodies in kidney transplantation by
flow cytometry. Transplantations Procedings, 1999;31:282-284 .
10. Scornik JC. Detection of alloantibodies by flow cytometry: relevance
to clinical transplantation Cytometry (Communications ‹n
Clinical Cytometry) 1995; 22: 259-263.
11. Strom TB. The immunopharmacology of graft rejection.
Transplant Proc. 1987;19: 128-129.

Thank you for copying data from http://www.arastirmax.com