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Abstracts / Human Immunology 73 (2012) 49–167
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ANGIOTENSIN II TYPE 1 RECEPTOR SENSITIZATION IN LUNG TRANSPLANTATION. Hooi Sian Eng 1, George J. Arnaoutakis 2, Donna Lucas 1, Timothy J. George 2, Claude A. Beaty 2, Christian A. Merlo 3,4, Mary S. Leffell 1, Ashish S. Shah 2, Andrea A. Zachary 1. 1 Immunogenetics Laboratory, Johns Hopkins University, Baltimore, MD, USA; 2 Division of Cardiac Surgery, The Johns Hopkins Medical Institutions, Baltimore, MD, USA; 3 Division of Pulmonary and Critical Care Medicine, The Johns Hopkins Medical Institutions, Baltimore, MD, USA; 4 Bloomberg School of Public Health, The Johns Hopkins Medical Institutions, Baltimore, MD, USA. Aim: Angiotensin II type 1 receptor (AT1R) is found in lung alveolar epithelium, the stroma surrounding epithelial layer of small airways, fibroblasts, vessel smooth muscle and alveolar macrophages. While the impact of HLA antibody in lung rejection is increasingly recognized, this association has not been studied for non-HLA antibodies such as anti-AT1R antibodies. Methods: We studied 112 patients who underwent lung transplantation in our center since the inception of the lung allocation score (LAS) in May 2005. Pre-transplant sera were screened for HLA and AT1R antibodies. 89 patients had clinical data available for analysis. AT1R antibody was tested on an ELISA platform while HLA antibody was defined using solid phase luminometric assays. AT1R levels were examined as continuous values. Test results were interpreted using a dichotomized cut-point of 17 U/ml as recommended by the manufacturer. Results: AT1R antibodies were positive in 31(35%) and negative in 58(65%) patients. Gender was not associated with AT1R sensitization (p = 0.2). Donor HLA specific antibodies were found in 10(11%) patients who were excluded from lung function and survival analysis. AT1R sensitization was not a significant predictor for lung function at 48 hours (p = 0.07) or at 6 month (p = 0.9). Further, presence of AT1R antibodies did not correlate with one year patient survival by Kaplan-Meier method (p = 0.8). AT1R sensitization was not a risk factor for rejection within 1 year (p = 0.5) or >1 year (p = 0.7) post-transplant. Post-transplant acute kidney injury was not associated with presence of AT1R antibodies. Post-operative care was also similar between the two groups (median length of stay in ICU, p = 0.9; median total hospital length of stay, p = 0.6). Conclusions: Our data show that AT1R sensitization does not correlate with early clinical outcomes in lung transplantation.
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DETERMINATION OF DONOR SPECIFIC ANTIBODY BY LUMINEX SINGLE ANTIGEN ASSAY IN TURKISH RENAL TRANSPLANT CANDIDATES. Sevim Gönen 1, Sevcan Bakkaloglu Ezgü 2, Galip Güz 3. 1 Faculty of Medicine Pediatric Nephroloy, Gazi University, Ankara, Turkey; 2 Faculty of Medicine Pediatric Nephroloy, Gazi University, Ankara, Turkey; 3 Faculty of Medicine Nephroloy, Gazi University, Ankara, Turkey. Aim: Luminex bead-based assays has been widely used for detection of anti-human leukocyte antigen (HLA) donor-specific antibodies (DSA) which are considered as a risk factor for acute rejection. Luminex single antigen assays might be more promising technique for determination of DSA. The aim of this study was to compare these techniques used to detect DSA in our Renal Transplant Candidates. Methods: Sixteen sera from 16 renal transplant candidates who had positive result with Luminex beadbased assays were screened for the presence of DSA by the Luminex single antigen assays. Results: All sera from 16 sensitized candidates were also positive for Luminex single antigen assay. The results were as follows: Seven sera HLA-A⁄2301(43,75%), five sera HLA-A 2402 (31,25%), five sera HLA-A 2403 (31,25%); six sera HLA-B⁄8202 (37,5%); six sera HLA-C⁄0501 (37,5%), five sera HLA-C 0801 (31,25%); seven sera HLA-DQA⁄0201 (43,75%); six sera HLA-DQB1⁄0401 (37.5%), six sera HLA-DQB1⁄0202 (37.5%), four sera HLA-DQB1⁄0402 (%25); four sera HLA-DRB1⁄0901 (25%), four sera HLA-DRB1⁄0701 (25%); and three sera HLA-DPB1⁄1701 (18.75%) were found to be positive. Conclusions: HLA-A⁄2301 and HLA-DQA⁄0201 positivity were found more frequent in Turkish renal transplant candidates. Detection of pre-transplant DSA by using Luminex single antigen assay would be beneficial for identifying high-risk candidates.
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ANGIOTENSIN II TYPE 1 RECEPTOR SENSITIZATION IN LUNG TRANSPLANTATION. Hooi Sian Eng 1, George J. Arnaoutakis 2, Donna Lucas 1, Timothy J. George 2, Claude A. Beaty 2, Christian A. Merlo 3,4, Mary S. Leffell 1, Ashish S. Shah 2, Andrea A. Zachary 1. 1 Immunogenetics Laboratory, Johns Hopkins University, Baltimore, MD, USA; 2 Division of Cardiac Surgery, The Johns Hopkins Medical Institutions, Baltimore, MD, USA; 3 Division of Pulmonary and Critical Care Medicine, The Johns Hopkins Medical Institutions, Baltimore, MD, USA; 4 Bloomberg School of Public Health, The Johns Hopkins Medical Institutions, Baltimore, MD, USA. Aim: Angiotensin II type 1 receptor (AT1R) is found in lung alveolar epithelium, the stroma surrounding epithelial layer of small airways, fibroblasts, vessel smooth muscle and alveolar macrophages. While the impact of HLA antibody in lung rejection is increasingly recognized, this association has not been studied for non-HLA antibodies such as anti-AT1R antibodies. Methods: We studied 112 patients who underwent lung transplantation in our center since the inception of the lung allocation score (LAS) in May 2005. Pre-transplant sera were screened for HLA and AT1R antibodies. 89 patients had clinical data available for analysis. AT1R antibody was tested on an ELISA platform while HLA antibody was defined using solid phase luminometric assays. AT1R levels were examined as continuous values. Test results were interpreted using a dichotomized cut-point of 17 U/ml as recommended by the manufacturer. Results: AT1R antibodies were positive in 31(35%) and negative in 58(65%) patients. Gender was not associated with AT1R sensitization (p = 0.2). Donor HLA specific antibodies were found in 10(11%) patients who were excluded from lung function and survival analysis. AT1R sensitization was not a significant predictor for lung function at 48 hours (p = 0.07) or at 6 month (p = 0.9). Further, presence of AT1R antibodies did not correlate with one year patient survival by Kaplan-Meier method (p = 0.8). AT1R sensitization was not a risk factor for rejection within 1 year (p = 0.5) or >1 year (p = 0.7) post-transplant. Post-transplant acute kidney injury was not associated with presence of AT1R antibodies. Post-operative care was also similar between the two groups (median length of stay in ICU, p = 0.9; median total hospital length of stay, p = 0.6). Conclusions: Our data show that AT1R sensitization does not correlate with early clinical outcomes in lung transplantation.
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DETERMINATION OF DONOR SPECIFIC ANTIBODY BY LUMINEX SINGLE ANTIGEN ASSAY IN TURKISH RENAL TRANSPLANT CANDIDATES. Sevim Gönen 1, Sevcan Bakkaloglu Ezgü 2, Galip Güz 3. 1 Faculty of Medicine Pediatric Nephroloy, Gazi University, Ankara, Turkey; 2 Faculty of Medicine Pediatric Nephroloy, Gazi University, Ankara, Turkey; 3 Faculty of Medicine Nephroloy, Gazi University, Ankara, Turkey. Aim: Luminex bead-based assays has been widely used for detection of anti-human leukocyte antigen (HLA) donor-specific antibodies (DSA) which are considered as a risk factor for acute rejection. Luminex single antigen assays might be more promising technique for determination of DSA. The aim of this study was to compare these techniques used to detect DSA in our Renal Transplant Candidates. Methods: Sixteen sera from 16 renal transplant candidates who had positive result with Luminex beadbased assays were screened for the presence of DSA by the Luminex single antigen assays. Results: All sera from 16 sensitized candidates were also positive for Luminex single antigen assay. The results were as follows: Seven sera HLA-A⁄2301(43,75%), five sera HLA-A 2402 (31,25%), five sera HLA-A 2403 (31,25%); six sera HLA-B⁄8202 (37,5%); six sera HLA-C⁄0501 (37,5%), five sera HLA-C 0801 (31,25%); seven sera HLA-DQA⁄0201 (43,75%); six sera HLA-DQB1⁄0401 (37.5%), six sera HLA-DQB1⁄0202 (37.5%), four sera HLA-DQB1⁄0402 (%25); four sera HLA-DRB1⁄0901 (25%), four sera HLA-DRB1⁄0701 (25%); and three sera HLA-DPB1⁄1701 (18.75%) were found to be positive. Conclusions: HLA-A⁄2301 and HLA-DQA⁄0201 positivity were found more frequent in Turkish renal transplant candidates. Detection of pre-transplant DSA by using Luminex single antigen assay would be beneficial for identifying high-risk candidates.
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