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Serological Typing of HLA-A, -B, and -C Antigens
Published in M. Kam, Jeffrey L. Bidwell, Handbook of HLA TYPING TECHNIQUES, 2020
The aim of screening patients’ sera is to determine whether any HLA antibody is present and its specificity(ies) if present. The methods used to test for such antibodies and the panel of lymphocytes used locally are described in the section,"HLA-A, -B, and -C Typing Reagents". A selected cryopreserved lymphocyte panel, which ensures testing of all the HLA specificities, or a random panel using the lymphocyte preparations typed in the laboratory, can be used. Whatever panel is used it is essential that the serum analysis be comprehensive. The screening result is usually expressed as the percentage of panel reactive antibody (% PRA), i.e., the percentage of the screening panel positive with the test serum.
Face transplantation
Published in John Dudley Langdon, Mohan Francis Patel, Robert Andrew Ord, Peter Brennan, Operative Oral and Maxillofacial Surgery, 2017
Ahmed M Hashem, Bahar Bassiri Gharb, Risal Djohan
Besides thorough history and physical exam, candidates undergo extensive testing including routine blood work, serum typing and cross-matching, human leukocyte antigen typing, panel-reactive antibody testing, Epstein–Barr virus (EBV) screening, cytomegalovirus (CMV) screening, human immunodeficiency virus (HIV) screening, hepatitis screening and random cultures (i.e. blood, sputum and urine) evaluating for drug-resistant organisms.
The humoral response to lung transplantation
Published in Wickii T. Vigneswaran, Edward R. Garrity, John A. Odell, LUNG Transplantation, 2016
Glen P. Westall, Miranda A. Paraskeva, Greg I. Snell
Both the CDC and flow cytometric assays rely on cellular targets. The CDC assay determines whether recipient serum can lyse non-self T or B lymphocytes. The lymphocytes are collected from a local representative population, as in the case of the panel-reactive antibody (PRA) assay or from the potential lung donor in the crossmatch test. The presence of autoantibodies may provide a false-positive crossmatch result, which is a scenario that can be avoided by the addition of dithiothreitol. The CDC does not differentiate between HLA class I and class II antibodies, nor between HLA and non-HLA antibodies.
Memory B cells and long-lived plasma cells in AMR
Published in Renal Failure, 2022
Wenlong Yue, Jia Liu, Xiaohu Li, Luman Wang, Jinfeng Li
Moreover, relevant studies have shown that memory B cells are produced much earlier than long-lived plasma cells; as a consequence, the memory B-cell-mediated DSA response cannot be effectively resolved [53]. As a result, panel reactive antibody (PRA)-negative patients are often presumed to be unsensitized patients. The patient’s degree of sensitization is based on detection of PRAs. Nevertheless, PRA-negative patients with a large number of memory B cells quickly produce DSAs when exogenous antigen reintroduction occurs. These patients may be clinically classified as unsensitized patients. Therefore, AMR can still occur after transplantation in some PRA-negative patients, perhaps because of the impact of memory B cells [54,55]. Quantifying memory B cells in peripheral blood and GCs and determining their functions may be important approaches to monitor AMR [56].
Association between cumulative rATG induction doses and kidney graft outcomes and adverse effects in kidney transplant patients: a systematic review and meta-analysis
Published in Expert Opinion on Biological Therapy, 2021
Keyhan Mohammadi, Behrouz Khajeh, Simin Dashti-Khavidaki, Sakineh Shab-bidar
The characteristics of the included studies are summarized in Table 1. Of 26 retrieved studies, three RCTs consisting of 154 patients [16,28,29] and 23 cohort studies consisting of 3457 patients [11,13,17,18,20,26,27,30–45] were included. Two studies [30,45], consisting of 190 patients did not report gender distribution in their population. Other studies consisted of 1306 women and 2115 men. The mean age of subjects was 50.36 ± 5.98 years with a range of 37 to 73.5 years. The mean age of the patients was not reported in one study [45]. The mean duration of patients’ follow-up was 23.36 ± 21.21 months (range 3 to 117 months). The mean administered cumulative doses of rATG considering all arms of all studies was 5.88 ± 2.8 mg/kg with a range of 1.5 to 18.75 mg/kg. Most of the included studies enrolled both the low and high immunological risk kidney transplant recipients. The high immunological risk definition varies across studies; however, patients with a history of prior renal allograft transplantation, elevated peak percent panel reactive antibody (PRA) and/or presence of donor-specific antibody were considered as high risk in most of the studies.
Physical activity and renal function in the Italian kidney transplant population
Published in Renal Failure, 2020
Lucia Masiero, Francesca Puoti, Lia Bellis, Letizia Lombardini, Valentina Totti, Maria Laura Angelini, Alessandra Spazzoli, Alessandro Nanni Costa, Massimo Cardillo, Gianluigi Sella, Giovanni Mosconi
Primarily, to evaluate the penchant for PA, considered as one of the two exposure variables of this study, the investigation recorded the patients’ characteristics related to the prognostic factors resulting from patient and organ survival analyses as reported in the annual CNT-SIT register publications [27]. The following demographic features were collected: donor age; recipient gender and age at the transplant (18–40, 41–50, 51–60, >60 years) and at the interview time (18–49, 50–59, 60–69, ≥70 years), grouped according to the quartile distribution; body mass index (BMI; normal weight, overweight, obese and underweight) [28]. The peri-transplant parameters evaluated were the following: diagnostic indication for transplant, Panel Reactive Antibody (PRA; 0–20; 21–79; ≥80), type of kidney transplant: single, double or combined with other organs (multi-organ kidney transplantation). In addition, other factors included in the analysis were: case-mix (the severity index for patients registered for a renal transplantdefined in terms of clinical complexity and comorbidities), divided into four groups (Standard, Weak, Intermediate and High) and dialysis vintage. The post-transplant factors analyzed were delayed graft function (DGF), defined as need for dialysis in the first 10 days after transplant, and follow-up duration (years) [29,30].