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9-P: Antibody Analysis in a Patient on the Renal Transplant Waiting List Undergoing Desensitization Treatment
Abstracts
9-P
S23
ANTIBODY ANALYSIS IN A PATIENT ON THE RENAL TRANSPLANT WAITING LIST UNDERGOING DESENSITIZATION TREATMENT. S. Dilioglou, G. Land. Pathology, Methodist Hospital, Houston, TX, USA. Aim: Desensitization protocols are commonly used in solid organ transplant candidates in order to decrease donor specific antibodies. We evaluated the antibody status in a 41 year old female patient with ESRD due to pregnancy-induced hypertension undergoing desensitization treatment as a means of receiving a potential cadaveric kidney. Methods: LABScreen® Single Antigen class I and II, One Lambda Inc. were used for antibody testing. The patient received one-1000 mg dosage IV infusion of Rituxan®, Genentech Inc., and three cycles of 1.3 mg/m2 per dose of Velcade®, Millennium Inc. Results: Table 1 shows the patient’s antibody profile before treatment. Following desensitization, there was a significant decrease of class I antibodies (p⬍0.05) while class II antibodies did not show a significant decrease (pⱖ0.05). The antibody levels of B39, B41 and B38 reached below our clinical threshold set at 4000 MFIs. Immediately following completion of the five month desensitization we were unable to perform the transplant. We monitored the antibodies three months after the five month desensitization. We compared the antibody titers during (or one month) after treatment to the antibody titers observed three months after treatment. There was an obvious increase in class I and II antibody titer. Table 1 Class I 4000-12000 MFI range B67 B42 B39 B41 B38
Class II
5000-14000 MFI range DR17 DR8 DR14 DR13 DR18 DQ2 DR11 DQ7 DR12 DR52 Conclusions: Desensitization is widely used in various solid organ transplant centers. However, clinical response to the treatment varies among patients. In our patient, we saw a desirable decrease in class I but an unremarkable response in the class II antibody titers. Based in our own clinical experience, the most optimal time for transplantation is immediately following desensitization.
9-P
S23
ANTIBODY ANALYSIS IN A PATIENT ON THE RENAL TRANSPLANT WAITING LIST UNDERGOING DESENSITIZATION TREATMENT. S. Dilioglou, G. Land. Pathology, Methodist Hospital, Houston, TX, USA. Aim: Desensitization protocols are commonly used in solid organ transplant candidates in order to decrease donor specific antibodies. We evaluated the antibody status in a 41 year old female patient with ESRD due to pregnancy-induced hypertension undergoing desensitization treatment as a means of receiving a potential cadaveric kidney. Methods: LABScreen® Single Antigen class I and II, One Lambda Inc. were used for antibody testing. The patient received one-1000 mg dosage IV infusion of Rituxan®, Genentech Inc., and three cycles of 1.3 mg/m2 per dose of Velcade®, Millennium Inc. Results: Table 1 shows the patient’s antibody profile before treatment. Following desensitization, there was a significant decrease of class I antibodies (p⬍0.05) while class II antibodies did not show a significant decrease (pⱖ0.05). The antibody levels of B39, B41 and B38 reached below our clinical threshold set at 4000 MFIs. Immediately following completion of the five month desensitization we were unable to perform the transplant. We monitored the antibodies three months after the five month desensitization. We compared the antibody titers during (or one month) after treatment to the antibody titers observed three months after treatment. There was an obvious increase in class I and II antibody titer. Table 1 Class I 4000-12000 MFI range B67 B42 B39 B41 B38
Class II
5000-14000 MFI range DR17 DR8 DR14 DR13 DR18 DQ2 DR11 DQ7 DR12 DR52 Conclusions: Desensitization is widely used in various solid organ transplant centers. However, clinical response to the treatment varies among patients. In our patient, we saw a desirable decrease in class I but an unremarkable response in the class II antibody titers. Based in our own clinical experience, the most optimal time for transplantation is immediately following desensitization.