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#49
DONOR-SPECIFIC ANTIBODY DETECTION CORRELATES WITH LATE HUMORAL REJECTION.
Anil Jain, M.D., Prabir Roy-chaudhury, M.D., Michael Cardi, M.D., E. Steve Woodle, M.D., Michael Hanaway, M.D., Joseph Austin, M.D., Shaoming Huang, M.D., Paul Brailey, B.S., Ramkrishnan Manohar, M.S. and Brian M. Susskind, Ph.D.. Cincinnati OH, USA, University of Cincinnati College of Medicine, 45267, Department of Internal Medicine; Cincinnati OH, USA, The Christ Hospital, 45267, Kidney and Hypertension Center; Cincinnati OH, USA, University of Cincinnati College of Medicine, 45267, Department of Surgery and Cincinnati OH, USA, Hoxworth Blood Center, 45267, Transplantation Immunology.
Endothelial inflammation in glomerular capillaries and presence of C4d in the peri-tubular and glomerular capillaries supports the diagnosis of late humoral rejection; however, neither is definitive. Using a novel combination of techniques (converting of Fluorescence Intensity (FI) of anti-HLA antibody bound to Labscreen PRA beads (One Lambda, Inc., Canoga Park, CA)) to Molecules of Equivalent Soluble Fluorescence (MESF) using Quantum 27 microbeads (Bangs Laboratories) and the Luminex multi-analyte microfluidics platform), we tested the correlation of donor specific anti-HLA antibodies (DSA) with kidney biopsy results for 12 patients with suspected graft rejection. Eight had biopsy-confirmed rejection, 6 of which had features consistent with humoral rejection, with a mean time to rejection of 893 days post-transplant (range: 310 - 2345). All 6 with humoral rejection were positive for DSA, whereas none of the others, including the two with cellular rejection, had DSA (x2=8.33, p<0.01). Of the 6 with humoral rejection and DSA, 2 had anti-HLA class I only, 2 had anti-class II only and 2 had both. DSA titers ranged from 100,000 to 700,000 MESF for class I, and 200,000 1,500,000 for class II. Thus, donor specific antibodies detected by this methodology were associated with late humoral rejection in 6/6 kidneys transplants recipients.