CASE REPORT: A DONOR-SPECIFIC ANTI-DP ANTIBODY APPARENTLY CAUSING ACUTE ANTIBODY MEDIATED REJECTION IN A KIDNEY RETRANSPLANT RECIPIENT

摘要

Although donor-specific anti-DP antibodies have been shown in several case reports (e.g., 1, 2) to be associated with accelerated kidney graft rejection and graft loss, Transplant Centers have continued to perform DP mis-matched transplants for patients known to have DP antibodies for several reasons: Donors are almost never typed for DP by the OPO laboratories; DP alleles cannot be listed in UNOS as unacceptable types; and, patients with DP antibodies usually have so many other HLA antibodies that they might otherwise never receive an opportunity for transplant. Published case reports do indicate that timely treatment for antibody mediated rejection (AMR) can at least prevent graft loss although long-term outcomes are not known. We herein report a case in which a donor-specific anti-DP antibody appeared to cause acute AMR. This event led to a change in our Transplant Center's policies relating to transplant candidates with strong DP antibodies.