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Histocompatibility Testing for Organ Transplantation Purposes in Albania: A Single Center Experience

Yıl 2014, Cilt: 2014 Sayı: 2, 121 - 125, 07.08.2014
https://doi.org/10.5152/balkanmedj.2014.13045

Öz

Background: Histocompatibility testing (HT) which includes donor-recipient human leukocyte antigen (HLA) matching, cross-match testing (XMT) and anti-HLA antibody searching are crucial examinations in solid organ transplantation aiming to avoid the hyperacute graft rejection and also to predict the immunological outcome of the graft. Aims: The aim of this study was to analyse the tissue typing data collected at the Laboratory of Immunology and Histocompatibility of the University Hospital Center of Tirana, Albania, in order to define those actions that should be taken for improvements in the situation of kidney transplantation in Albania. Study Design: Descriptive study. Methods: The donor/recipient cross-match testing was performed through a standard complement-dependent cytotoxicity (CDC) assay using separated donor T and B cells that were tested in parallel with the recipient serum sample. All recipient sera were screened for anti-Class I and anti-Class II HLA antibodies using a bead based Luminex anti-HLA antibody screening test. In the case of detected positivity, an allele-specific anti-HLA antibody determination was conducted with the respective Luminex anti-Class I and Class II HLA antibody determination kits. Results: A total of 174 recipients and 202 donors were typed for the purpose of living donor kidney transplantation at our laboratory between January 2006 and December 2012. The mean age and female gender proportion of patients were 34.9 years and 34.5%, respectively, and 48.0 years and 65.3% for the donors, respectively. Here, 25.9% of the patients reported a positive complement-dependent cytotoxicity cross-match test and/or a positive anti-HLA antibody testing result. Eighteen patients that were negative for the complement-dependent cytotoxicity cross-match test were positive for anti-HLA antibodies. Conclusion: The predominant causes of end-stage renal disease (ESRD) in our patient population are chronic pyelonephritis and glomerulonephritis. The female gender is significantly more frequent among donors, which emphasises the need for more gender equity as far as the altruistic willingness for organ donation is concerned. The significant number of patients with Luminex anti-HLA antibody positivity combined with complement-dependent cytotoxicity cross-match negative results underlines the necessity of using additional methods like cell-based flow cytometry or bead-based Luminex anti-HLA antibody assays for the detection of anti-donor-specific antibodies. We also suggest that the number of kidney transplantations in Albania needs to be increased significantly by expanding it with paired exchange living donation and also by implementing an efficient deceased donor kidney transplantation program. (Balkan Med J 2014;31:121-5).

Kaynakça

  • Claas FHJ, Dankers MK, Oudshoorn M, van Rood JJ, Mulder A, Roelen DL, et al. Differential immunogenicity of HLA mismatches in clinical transplantation. Transpl Immunol 2005;14:187-91. [CrossRef]
  • Cecka JM. HLA matching for organ transplantation…Why not? Int J Immunogenet 2010;37:323-7. [CrossRef]
  • Patel R, Terasaki PI. Significance of the positive crossmatch in kidney transplantation. N Engl J Med 1969;280:735-9. [CrossRef]
  • Billen EV, Christiaans MH, van den Berg-Loonen EM. Clinical relevance of Luminex donor-specific crossmatches: data from 165 renal transplants. Tissue Antigens 2009;74:205-12. [CrossRef]
  • Batal I, Zeevi A, Lunz JG III, Aggarwal N, Shapiro R, Randhawa P, et al. Antihuman leukocyte antigen-specific antibody strength determined by complement-dependent or solid-phase assays can predict positive donor-specific crossmatches. Arch Pathol Lab Med 2010;34:1534-40.
  • Khodadadi L, Adib M, Pourazar A. Immunoglobulin Class (IgG, IgM) Determination by Dithiothreitol in Sensitized Kidney Transplant Candidates. Transplant Proc 2006;38:2813-5. [CrossRef]
  • Heemann U, Renders L. State of Living Kidney Donation in Europe. Nephrol Dial Transplant 2012;27:2166-70. [CrossRef]
  • European Commission. Organ donation and transplantation, facts and figures journalist workshop 9 Oct 2012. Available from: URL: http://ec.europa.eu/ health/blood_tissue_organs/docs/ev_20121009_facts_figures.pdf.
  • Franke GH, Yücetin L, Yaman H, Reimer J, Demirbas A. Disease-specific quality of life in Turkish patients after successful kidney transplantation. Transplant Proc 2006;38:457-9. [CrossRef]
  • Knoll GA. Is Kidney Transplantation for Everyone? The Example of the Older Dialysis Patient. Clin J Am Soc Nephrol 2009;4:2040-4. [CrossRef] Gures N, Gurluler E, Berber I, Karayagiz AH, Kemik O, Sumer A, et al. Comparison of the right and left laparoscopic live donor nephrectomies: a clinical case load. Eur Rev Med Pharmacol Sci 2013;17:1389-94.
  • Centers for Disease Control and Prevention (CDC). Prevalence of chronic kidney disease and associated risk factors-United States, 1999200 MMWR Morb Mortal Wkly Rep 2007;56:161-5.
  • Santori G, Barocci S, Fontana I, Bertocchi M, Tagliamacco A, Biticchi R, et al. Kidney transplantation from living donors genetically related or unrelated to the recipients: a single-center analysis. Transplant Proc 2012;44:1892-6. [CrossRef]
  • Liu G, Li X, Liu T, Zhao X, Zhang S, Wang J, et al. Gender disparity of living donor renal transplantation in East China. Clin Transplant 2013;27:98-103. [CrossRef]
  • Zimmerman D, Donnelly S, Miller J, Steward D, Albert SE. Gender Disparity in living renal transplant donation. Am J Kidney Dis 2000;36:534-40. [CrossRef]
  • Lee HS, Kim MS, Kim YS, Joo DJ, Ju MK, Kim SJ, et al. Analysis of transplant outcomes after five or six human leukocyte antigenmismatched living donor kidney transplantation. Transplant Proc 2012;44:273-5. [CrossRef]
  • Colombo MB, Haworth SE, Poli F, Nocco A, Puglisi G, Innocente A, et al. Luminex technology for anti-HLA antibody screening: evaluation of performance and of impact on laboratory routine. Cytometry B Clin Cytom 2007;72:465-71. [CrossRef]
  • Lee PC, Ozawa M, Hung CJ, Lin YJ, Chang SS, Chou TC. Reappraisal of HLA antibody analysis and crossmatching in kidney transplantation. Transplant Proc 2009;41:95-8. [CrossRef]
  • Balkan Med J, Vol. 31, No. 2, 2014
  • U.S. Department of Health and Human Services, Health Resources and Services Administration, Healthcare Systems Bureau, Division of Transplantation, Rockville, MD. 2009 Annual Report of the U.S. Organ Procurement and Transplantation Network and the Scientific Registry of Transplant Recipients: Transplant Data 1999-2008. U.S. Department of Health and Human Services; 2009.
  • Hwang HS, Yoon HE, Choi BS, Oh EJ, Kim JI, Moon IS, et al. B-cell Complement dependent cytotoxic crossmatch positivity is an independent risk factor for long-term renal allograft survival. J Korean Med Sci 2011;26:528-33. [CrossRef]
  • Minucci PB, Grimaldi V, Casamassimi A, Cacciatore F, Sommese L, Picascia A, et al. Methodologies for anti-HLA antibody screening in patients awaiting kidney transplant: a comparative study. Exp Clin Transplant 2011;9:381-6.
  • Lindemann M, Nyadu B, Heinemann FM, Kribben A, Paul A, Horn PA, et al. High negative predictive value of an amplified flow cytometry crossmatch before living donor kidney transplantation. Hum Immunol 2010;71:771-6. [CrossRef]
  • Lee PC, Zhu L, Terasaki PI, Everly MJ. HLA-specific antibodies developed in the first year posttransplant are predictive of chronic rejection and renal graft loss. Transplantation 2009;88:568-74. [CrossRef]
  • Yabu JM, Higgins JP, Chen G, Sequeira F, Busque S, Tyan DB. C1qfixing human leukocyte antigen antibodies are specific for predicting transplant glomerulopathy and late graft failure after kidney transplantation. Transplantation 2011;91:342-7. [CrossRef]

Histocompatibility Testing for Organ Transplantation Purposes in Albania: A Single Center Experience

Yıl 2014, Cilt: 2014 Sayı: 2, 121 - 125, 07.08.2014
https://doi.org/10.5152/balkanmedj.2014.13045

Öz

Kaynakça

  • Claas FHJ, Dankers MK, Oudshoorn M, van Rood JJ, Mulder A, Roelen DL, et al. Differential immunogenicity of HLA mismatches in clinical transplantation. Transpl Immunol 2005;14:187-91. [CrossRef]
  • Cecka JM. HLA matching for organ transplantation…Why not? Int J Immunogenet 2010;37:323-7. [CrossRef]
  • Patel R, Terasaki PI. Significance of the positive crossmatch in kidney transplantation. N Engl J Med 1969;280:735-9. [CrossRef]
  • Billen EV, Christiaans MH, van den Berg-Loonen EM. Clinical relevance of Luminex donor-specific crossmatches: data from 165 renal transplants. Tissue Antigens 2009;74:205-12. [CrossRef]
  • Batal I, Zeevi A, Lunz JG III, Aggarwal N, Shapiro R, Randhawa P, et al. Antihuman leukocyte antigen-specific antibody strength determined by complement-dependent or solid-phase assays can predict positive donor-specific crossmatches. Arch Pathol Lab Med 2010;34:1534-40.
  • Khodadadi L, Adib M, Pourazar A. Immunoglobulin Class (IgG, IgM) Determination by Dithiothreitol in Sensitized Kidney Transplant Candidates. Transplant Proc 2006;38:2813-5. [CrossRef]
  • Heemann U, Renders L. State of Living Kidney Donation in Europe. Nephrol Dial Transplant 2012;27:2166-70. [CrossRef]
  • European Commission. Organ donation and transplantation, facts and figures journalist workshop 9 Oct 2012. Available from: URL: http://ec.europa.eu/ health/blood_tissue_organs/docs/ev_20121009_facts_figures.pdf.
  • Franke GH, Yücetin L, Yaman H, Reimer J, Demirbas A. Disease-specific quality of life in Turkish patients after successful kidney transplantation. Transplant Proc 2006;38:457-9. [CrossRef]
  • Knoll GA. Is Kidney Transplantation for Everyone? The Example of the Older Dialysis Patient. Clin J Am Soc Nephrol 2009;4:2040-4. [CrossRef] Gures N, Gurluler E, Berber I, Karayagiz AH, Kemik O, Sumer A, et al. Comparison of the right and left laparoscopic live donor nephrectomies: a clinical case load. Eur Rev Med Pharmacol Sci 2013;17:1389-94.
  • Centers for Disease Control and Prevention (CDC). Prevalence of chronic kidney disease and associated risk factors-United States, 1999200 MMWR Morb Mortal Wkly Rep 2007;56:161-5.
  • Santori G, Barocci S, Fontana I, Bertocchi M, Tagliamacco A, Biticchi R, et al. Kidney transplantation from living donors genetically related or unrelated to the recipients: a single-center analysis. Transplant Proc 2012;44:1892-6. [CrossRef]
  • Liu G, Li X, Liu T, Zhao X, Zhang S, Wang J, et al. Gender disparity of living donor renal transplantation in East China. Clin Transplant 2013;27:98-103. [CrossRef]
  • Zimmerman D, Donnelly S, Miller J, Steward D, Albert SE. Gender Disparity in living renal transplant donation. Am J Kidney Dis 2000;36:534-40. [CrossRef]
  • Lee HS, Kim MS, Kim YS, Joo DJ, Ju MK, Kim SJ, et al. Analysis of transplant outcomes after five or six human leukocyte antigenmismatched living donor kidney transplantation. Transplant Proc 2012;44:273-5. [CrossRef]
  • Colombo MB, Haworth SE, Poli F, Nocco A, Puglisi G, Innocente A, et al. Luminex technology for anti-HLA antibody screening: evaluation of performance and of impact on laboratory routine. Cytometry B Clin Cytom 2007;72:465-71. [CrossRef]
  • Lee PC, Ozawa M, Hung CJ, Lin YJ, Chang SS, Chou TC. Reappraisal of HLA antibody analysis and crossmatching in kidney transplantation. Transplant Proc 2009;41:95-8. [CrossRef]
  • Balkan Med J, Vol. 31, No. 2, 2014
  • U.S. Department of Health and Human Services, Health Resources and Services Administration, Healthcare Systems Bureau, Division of Transplantation, Rockville, MD. 2009 Annual Report of the U.S. Organ Procurement and Transplantation Network and the Scientific Registry of Transplant Recipients: Transplant Data 1999-2008. U.S. Department of Health and Human Services; 2009.
  • Hwang HS, Yoon HE, Choi BS, Oh EJ, Kim JI, Moon IS, et al. B-cell Complement dependent cytotoxic crossmatch positivity is an independent risk factor for long-term renal allograft survival. J Korean Med Sci 2011;26:528-33. [CrossRef]
  • Minucci PB, Grimaldi V, Casamassimi A, Cacciatore F, Sommese L, Picascia A, et al. Methodologies for anti-HLA antibody screening in patients awaiting kidney transplant: a comparative study. Exp Clin Transplant 2011;9:381-6.
  • Lindemann M, Nyadu B, Heinemann FM, Kribben A, Paul A, Horn PA, et al. High negative predictive value of an amplified flow cytometry crossmatch before living donor kidney transplantation. Hum Immunol 2010;71:771-6. [CrossRef]
  • Lee PC, Zhu L, Terasaki PI, Everly MJ. HLA-specific antibodies developed in the first year posttransplant are predictive of chronic rejection and renal graft loss. Transplantation 2009;88:568-74. [CrossRef]
  • Yabu JM, Higgins JP, Chen G, Sequeira F, Busque S, Tyan DB. C1qfixing human leukocyte antigen antibodies are specific for predicting transplant glomerulopathy and late graft failure after kidney transplantation. Transplantation 2011;91:342-7. [CrossRef]
Toplam 24 adet kaynakça vardır.

Ayrıntılar

Birincil Dil İngilizce
Konular Sağlık Kurumları Yönetimi
Bölüm Makaleler
Yazarlar

Erkena Shyti Bu kişi benim

Alma Idrizi Bu kişi benim

Genc Sulcebe Bu kişi benim

Yayımlanma Tarihi 7 Ağustos 2014
Yayımlandığı Sayı Yıl 2014 Cilt: 2014 Sayı: 2

Kaynak Göster

APA Shyti, E., Idrizi, A., & Sulcebe, G. (2014). Histocompatibility Testing for Organ Transplantation Purposes in Albania: A Single Center Experience. Balkan Medical Journal, 2014(2), 121-125. https://doi.org/10.5152/balkanmedj.2014.13045
AMA Shyti E, Idrizi A, Sulcebe G. Histocompatibility Testing for Organ Transplantation Purposes in Albania: A Single Center Experience. Balkan Medical Journal. Şubat 2014;2014(2):121-125. doi:10.5152/balkanmedj.2014.13045
Chicago Shyti, Erkena, Alma Idrizi, ve Genc Sulcebe. “Histocompatibility Testing for Organ Transplantation Purposes in Albania: A Single Center Experience”. Balkan Medical Journal 2014, sy. 2 (Şubat 2014): 121-25. https://doi.org/10.5152/balkanmedj.2014.13045.
EndNote Shyti E, Idrizi A, Sulcebe G (01 Şubat 2014) Histocompatibility Testing for Organ Transplantation Purposes in Albania: A Single Center Experience. Balkan Medical Journal 2014 2 121–125.
IEEE E. Shyti, A. Idrizi, ve G. Sulcebe, “Histocompatibility Testing for Organ Transplantation Purposes in Albania: A Single Center Experience”, Balkan Medical Journal, c. 2014, sy. 2, ss. 121–125, 2014, doi: 10.5152/balkanmedj.2014.13045.
ISNAD Shyti, Erkena vd. “Histocompatibility Testing for Organ Transplantation Purposes in Albania: A Single Center Experience”. Balkan Medical Journal 2014/2 (Şubat 2014), 121-125. https://doi.org/10.5152/balkanmedj.2014.13045.
JAMA Shyti E, Idrizi A, Sulcebe G. Histocompatibility Testing for Organ Transplantation Purposes in Albania: A Single Center Experience. Balkan Medical Journal. 2014;2014:121–125.
MLA Shyti, Erkena vd. “Histocompatibility Testing for Organ Transplantation Purposes in Albania: A Single Center Experience”. Balkan Medical Journal, c. 2014, sy. 2, 2014, ss. 121-5, doi:10.5152/balkanmedj.2014.13045.
Vancouver Shyti E, Idrizi A, Sulcebe G. Histocompatibility Testing for Organ Transplantation Purposes in Albania: A Single Center Experience. Balkan Medical Journal. 2014;2014(2):121-5.