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Combined liver-kidney transplantation: Analysis of patients with preformed lymphocytotoxic antibody

Fung, J and Makowka, L and Tzakis, A and Klintmalm, G and Duquesnoy, R and Gordon, R and Todo, S and Griffin, M and Starzl, T (1988) Combined liver-kidney transplantation: Analysis of patients with preformed lymphocytotoxic antibody. Transplantation Proceedings, 20 (1 SUPP). 88 - 91. ISSN 0041-1345

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Abstract

In this report, we address combined liver-kidney transplantation, with particular attention to the apparent phenomenon of protection of kidney allografts to antibody mediated destruction by liver allografts. Four patients were found to have positive crossmatch before the liver phase of the combined transplant (pre-OT/KT samples). These positive crossmatches were due entirely to anti-HLA class I antibodies, as demonstrated by their removal by immunoabsorption on pololed platelets. In three of these patients, post-OT/pre-KT samples showed a conversion to a negative crossmatch (in the fourth patient this was not done). A kidney allograft, harveted from the same donor, was then placed into the recipient, and in patients no. 3, 7, and 12, good initial function was noted. In one of these patients was there evidence of hyperacute rejection. Post-OT/KT samples were collected in patients no. 3, 7, and 8, and then analyzed for the reappearance of donor specific lymphocytotoxic antibodies in the posttransplant period (data on patient no. 12 was not available at time of preparation). Lymphocytotoxic antibodies with donor specificity could not be detected in any of the samples during the first week posttransplant. The decrease in %PRA and conversion of a positive to negative crossmatch following liver transplantation was correlated to the HLA specificty of the antibody found in the pretransplant serum and the HLA type of the tranplanted organs. In the two instances where an HLA specificity could be determined by panel analysis, transplantation with donor organs bearing these HLA specificities led to a specific disppearance of these antibodies during the postransplant phase.


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Details

Item Type: Article
Status: Published
Creators/Authors:
CreatorsEmailPitt UsernameORCID
Fung, J
Makowka, L
Tzakis, A
Klintmalm, G
Duquesnoy, R
Gordon, R
Todo, S
Griffin, M
Starzl, Ttes11@pitt.eduTES11
Centers: Other Centers, Institutes, or Units > Thomas E. Starzl Transplantation Institute
Date: 1 January 1988
Date Type: Publication
Journal or Publication Title: Transplantation Proceedings
Volume: 20
Number: 1 SUPP
Page Range: 88 - 91
Institution: University of Pittsburgh
Refereed: Yes
ISSN: 0041-1345
Other ID: uls-drl:31735062130145, Starzl CV No. 864
Date Deposited: 08 Apr 2010 17:14
Last Modified: 29 Jan 2019 15:55
URI: http://d-scholarship.pitt.edu/id/eprint/4250

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