Monoclonal Antibody Therapy does not Abrogate Rejection Risk in Renal Transplant Recipients

Abstract

Event Abstract Back to Event Monoclonal Antibody Therapy does not Abrogate Rejection Risk in Renal Transplant Recipients Sanjeev Goswami1* and Narinder K. Mehra1 1 All India Institute of Medical Sciences, Transplant Immunology & Immunogenetics, India Monoclonal antibodies are being increasingly used as therapeutic agents in medicine. Rituximab (anti-CD20) and Daclizumab (anti-IL2Rα) are two such monoclonal antibodies used to prevent organ rejection, but are not fail-safe. We have analyzed the pre and post-transplant antibody profile in serum of renal transplant recipients receiving Rituximab and /or Daclizumab. Study Group: Kidney recipients with acute rejection and having PRA > 10% pre-transplant were selected for the study (n=11). Those with well-functioning grafts served as the control group (n=15). Serum from these recipients was analyzed retrospectively by LABScreen kits for anti-HLA class-I, class-II and anti-MICA antibodies. Results: Patients undergoing graft dysfunction showed the presence of either anti-HLA or anti-MICA antibodies or both. Acute antibody-mediated rejection was preferentially associated with the presence of pre-transplant anti-HLA and/or anti-MICA antibodies (9/11 cases, p<0.05). Pre-transplant anti-MICA antibodies alone led to hyperacute rejection in two cases and pre-transplant DSA led to hyperacute rejection in one case. Two cases that had acute rejection within 10 days post-transplant revealed anti-HLA and anti-MICA antibodies in the pre-transplant serum. Conclusion: A negative CDC cross-match following rituximab/daclizumab therapy does not imply absence of anti-HLA or anti-MICA antibodies in the recipient. Antibodies may still be detectable by more sensitive methods like Luminex and presence of pre-transplant anti-HLA and/or anti-MICA antibodies correlates with poor graft outcome in renal transplant. Further analysis on Luminex has shown that de-novo antibodies post-transplant, to HLA class-I/II or MICA indicate poor prognosis and may lead to accelerated graft rejection in such cases. Keywords: Renal, transplant, antibody, Monitoring, monoclonal Conference: 15th International Congress of Immunology (ICI), Milan, Italy, 22 Aug - 27 Aug, 2013. Presentation Type: Abstract Topic: Translational immunology and immune intervention Citation: Goswami S and Mehra NK (2013). Monoclonal Antibody Therapy does not Abrogate Rejection Risk in Renal Transplant Recipients. Front. Immunol. Conference Abstract: 15th International Congress of Immunology (ICI). doi: 10.3389/conf.fimmu.2013.02.00825 Copyright: The abstracts in this collection have not been subject to any Frontiers peer review or checks, and are not endorsed by Frontiers. They are made available through the Frontiers publishing platform as a service to conference organizers and presenters. The copyright in the individual abstracts is owned by the author of each abstract or his/her employer unless otherwise stated. Each abstract, as well as the collection of abstracts, are published under a Creative Commons CC-BY 4.0 (attribution) licence (https://creativecommons.org/licenses/by/4.0/) and may thus be reproduced, translated, adapted and be the subject of derivative works provided the authors and Frontiers are attributed. For Frontiers’ terms and conditions please see https://www.frontiersin.org/legal/terms-and-conditions. Received: 21 Jun 2013; Published Online: 22 Aug 2013. * Correspondence: Dr. Sanjeev Goswami, All India Institute of Medical Sciences, Transplant Immunology & Immunogenetics, New Delhi, Delhi, 110029, India, goswamisanjeev@yahoo.com Login Required This action requires you to be registered with Frontiers and logged in. To register or login click here. Abstract Info Abstract The Authors in Frontiers Sanjeev Goswami Narinder K Mehra Google Sanjeev Goswami Narinder K Mehra Google Scholar Sanjeev Goswami Narinder K Mehra PubMed Sanjeev Goswami Narinder K Mehra Related Article in Frontiers Google Scholar PubMed Abstract Close Back to top Javascript is disabled. Please enable Javascript in your browser settings in order to see all the content on this page.