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Title

Changes of circulating antibody levels induced by ABO antibody adsorption for ABO-incompatible kidney transplantation
Authors
Valli, P. V.
Puga Yung, Gisella
Fehr, T.
Schulz-Huotari, C.
Kaup, N.
Gungor, T.
Ambuhl, P.
Weber, M.
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Published in American Journal of Transplantation. 2009, vol. 9, no. 5, p. 1072-1080
Abstract ABO-incompatible kidney transplantation using immunoadsorption to remove anti-A/B antibodies has become a successful clinical practice. Since the data on the specificity of the ABO columns are controversial, the present study assessed the efficiency and specificity of the ABO immunoadsorption, the effect on total immunoglobulins and antibodies previously induced by vaccination. Anti-A/B antibodies were measured by agglutination and ABO flow cytometry, total IgG/IgM, carbohydrate- and protein-specific antibodies by nephelometry and ELISA. The first immunoadsorption not only efficiently reduced donor-specific anti-A/B IgM (81%) and IgG (56%) but also reduced compatible anti-A/B IgM (59%) and IgG (34%). The measurements of antidonor A/B antibodies by direct agglutination (IgM) or flow cytometry better represented the effective antibody levels than the indirect agglutination test (IgG). The median reduction of total IgM and total IgG levels after a single immunoadsorption was 34% and 18%, respectively. Antibodies against pneumococcus and haemophilus polysaccharide antigens were significantly reduced, whereas antitetanus and antidiphtheria protein antibodies were not affected. Intravenous immunoglobulin administration restored the protective anticarbohydrate antibody levels. In summary, immunoadsorption efficiently removed antidonor A/B antibodies, but was not specific for A/B antigens. Anti-A/B antibody levels as determined by ABO flow cytometry are useful to establish the minimal number of immunoadsorptions needed for successful ABO-incompatible transplantation.
Keywords ABO Blood-Group System/*immunology — Adult — *Blood Group Incompatibility/immunology — Enzyme-Linked Immunosorbent Assay — Flow Cytometry — Hemagglutination Tests — Humans — Immunoglobulin G/blood — Immunoglobulin M/blood — Isoantibodies/*blood — Kidney Transplantation/*immunology — Middle Aged — Treatment Outcome — Young Adult
Identifiers
PMID: 19344433
Full text
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Other version: http://onlinelibrary.wiley.com/store/10.1111/j.1600-6143.2009.02579.x/asset/j.1600-6143.2009.02579.x.pdf?v=1&t=gzs8co...
Structures
Faculté de médecine / Section de médecine clinique / Département de médecine interne des spécialités
Research group Groupe Seebach Jorg Dieter (transplantation et immunologie) (856)
Citation
(ISO format) 		VALLI, P. V. et al. Changes of circulating antibody levels induced by ABO antibody adsorption for ABO-incompatible kidney transplantation. In: American Journal of Transplantation, 2009, vol. 9, n° 5, p. 1072-1080. https://archive-ouverte.unige.ch/unige:20144

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Deposited on : 2012-04-23

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