IMPACT OF HLA ANTIBODY DEVELOPMENT ON RENAL GRAFT FAILURE AND FUNCTION

摘要

In recent years, post-transplant antibody screening and monitoring have been used in many research studies to detect and define active immunologic response, and their use has been advocated as a biomarker in transplantation. Nonetheless, clinicians remain hesitant to apply these programs routinely to all post-transplant cases. They question the value of testing for antibody those patients who have not experienced graft dysfunction, given that many continue to enjoy excellent allograft function even when antibodies are present for a long time. These clinicians doubt that the evidence for the post-transplant appearance of antibodies as a reliable predictor of potential (or likely) graft failure is strong enough to justify the cost of monitoring all transplant patients for that appearance. To address the question of whether or not post-transplant antibodies significantly predict graft dysfunction, we retrospectively studied patients who had chronic renal graft failure, matched with patients who had been transplanted at about the same time, and had stable functioning grafts, comparing the matched pairs to determine if development of antibodies post-transplant correlated with graft outcome.