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Clinical Significance of Alloantibodies in Hand Transplantation : A Multicenter Study

Berglund, Erik (author)
Karolinska Institutet
Andersen Ljungdahl, Mette (author)
Karolinska Inst, Karolinska Univ Hosp, Dept Transplantat Surg, Div Transplantat Surg,CLINTEC, Stockholm, Sweden
Bogdanovic, Darko (author)
Karolinska Inst, Karolinska Univ Hosp, Dept Transplantat Surg, Div Transplantat Surg,CLINTEC, Stockholm, Sweden
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Berglund, David, 1984- (author)
Uppsala universitet,Klinisk immunologi
Wadstroem, Jonas (author)
Karolinska Inst, Karolinska Univ Hosp, Dept Transplantat Surg, Div Transplantat Surg,CLINTEC, Stockholm, Sweden
Kowalski, Jan (author)
JK Biostat AB, Stockholm, Sweden
Brandacher, Gerald (author)
Johns Hopkins Univ, Sch Med, Dept Plast & Reconstruct Surg, Baltimore, MD USA
Kaminska, Dorota (author)
Wroclaw Med Univ, Dept Nephrol & Transplantat Med, Wroclaw, Poland
Kaufman, Christina L. (author)
Christine M Kleinert Inst Hand & Microsurg, Louisville, KY USA
Talbot, Simon G. (author)
Brigham & Womens Hosp, Div Plast Surg, 75 Francis St, Boston, MA 02115 USA
Azari, Kodi (author)
Univ Calif Los Angeles, David Geffen Sch Med, Dept Orthopaed Surg, Div Plast Surg, Los Angeles, CA 90095 USA
Landin, Luis (author)
Hosp Univ La Paz, Div Plast & Reconstruct Surg, IdiPaz, FIBHULP, Madrid, Spain
Hoehnke, Christoph (author)
Klinikum Memmingen, Div Plast & Reconstruct Surg, Memmingen, Germany;Tech Univ Munich, Munich, Germany
Dwyer, Karen M. (author)
Deakin Univ, Sch Med, Fac Hlth, Geelong, Vic, Australia
Cavadas, Pedro C. (author)
Clin Cavadas, Plast & Reconstruct Surg Div, Valencia, Spain
Thione, Alessandro (author)
Clin Cavadas, Plast & Reconstruct Surg Div, Valencia, Spain
Clarke, Brendan (author)
Leeds Gen Infirm, Dept Plast & Reconstruct Surg, Leeds, W Yorkshire, England
Kay, Simon (author)
Leeds Gen Infirm, Dept Plast & Reconstruct Surg, Leeds, W Yorkshire, England
Wilks, Dan (author)
Leeds Gen Infirm, Dept Plast & Reconstruct Surg, Leeds, W Yorkshire, England
Iyer, Subramania (author)
Amrita Inst Med Sci, Plast Reconstruct Surg, Kochi, Kerala, India
Iglesias, Martin (author)
Inst Nacl Ciencias Med & Nutr Salvador Zubiran, Mexico City, DF, Mexico
Ozkan, Omer (author)
Akdeniz Univ, Fac Med, Dept Plast & Reconstruct Surg, Antalya, Turkey
Ozkan, Ozlenen (author)
Akdeniz Univ, Fac Med, Dept Plast & Reconstruct Surg, Antalya, Turkey
Krapf, Johanna (author)
Innsbruck Med Univ, Dept Plast & Reconstruct Surg, Innsbruck, Austria
Weissenbacher, Annemarie (author)
Med Univ Innsbruck, Ctr Operat Med, Dept Visceral Transplant & Thorac Surg, Innsbruck, Austria;Univ Oxford, Churchill Hosp, Oxford Transplant Ctr, Nuffield Dept Surg Sci, Oxford, England
Petruzzo, Palmina (author)
Hop Edouard Herriot, HCL, Dept Transplantat, Lyon, France
Schneeberger, Stefan (author)
Med Univ Innsbruck, Ctr Operat Med, Dept Visceral Transplant & Thorac Surg, Innsbruck, Austria
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 (creator_code:org_t)
LIPPINCOTT WILLIAMS & WILKINS, 2019
2019
English.
In: Transplantation. - : LIPPINCOTT WILLIAMS & WILKINS. - 0041-1337 .- 1534-6080. ; 103:10, s. 2173-2182
Related links:
https://urn.kb.se/re...
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https://doi.org/10.1...
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  • Journal article (peer-reviewed)
Abstract Subject headings
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  • Background. Donor-specific antibodies (DSAs) have a strong negative correlation with long-term survival in solid organ transplantation. Although the clinical significance of DSA and antibody-mediated rejection (AMR) in upper extremity transplantation (UET) remains to be established, a growing number of single-center reports indicate their presence and potential clinical impact. Methods. We present a multicenter study assessing the occurrence and significance of alloantibodies in UET in reference to immunological parameters and functional outcome. Results. Our study revealed a high prevalence and early development of de novo DSA and non-DSA (43%, the majority detected within the first 3 postoperative y). HLA class II mismatch correlated with antibody development, which in turn significantly correlated with the incidence of acute cellular rejection. Cellular rejections preceded antibody development in almost all cases. A strong correlation between DSA and graft survival or function cannot be statistically established at this early stage but a correlation with a lesser outcome seems to emerge. Conclusions. While the phenotype and true clinical effect of AMR remain to be better defined, the high prevalence of DSA and the correlation with acute rejection highlight the need for optimizing immunosuppression, close monitoring, and the relevance of an HLA class II match in UET recipients.

Subject headings

MEDICIN OCH HÄLSOVETENSKAP  -- Klinisk medicin -- Kirurgi (hsv//swe)
MEDICAL AND HEALTH SCIENCES  -- Clinical Medicine -- Surgery (hsv//eng)

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