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Nephrol Dial Transplant (2001) 16: 897-904
© 2001 European Renal Association-European Dialysis and Transplant Association

Invited Comment

HLA-specific alloantibodies and renal graft outcome

Suchitra Sumitran-Holgersson

Division of Clinical Immunology, Karolinska Institutet, Huddinge University Hospital, Huddinge, Sweden

Abstract

HLA-specific humoral immunity, as a result of recipient allosensitization, induces hyperacute rejection of allogenic kidney grafts. Cross-match tests are performed to avoid this complication. However, current techniques do not allow determination of HLA-specificity of donor-reactive antibodies in the acute cadaver-donor situation. New methods are described and discussed in this report as well as the alloantibody specificities that are of clinical importance. Alloantibodies not only mediate hyperacute rejection but may also participate in the acute rejection of organ grafts. Clinical associations between early immunological complications, such as acute rejection, in heart, liver and kidney allografted patients and pre-transplantation humoral alloimmunity emphasize the need for proper determination of donor-specific humoral immunity prior to transplantation.

Notes

Correspondence and offprint requests to: Dr Suchitra Sumitran-Holgersson, Division of Clinical Immunology, F-79, Huddinge University Hospital AB, S-141 86 Stockholm, Sweden.


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