BibTex RIS Kaynak Göster

Appoaches to anti-HLA antibody profiles in patients waiting for renal re-transolantation

Yıl 2009, Cilt: 15 Sayı: 3, 36 - 41, 01.04.2009

Gonca Emel Karahan Fatma Sevcan Oğuz Mahmut N. Çarin

Öz

This review focuses on the mechanisms of anti-HLA antibody, development in patients waiting for a renal re-transplantation. Pre'r existence or post transplant de novo production of these antibodies', have been found to contribute to renal allograft failure in years. In addition to the detrimental effect of donor specific and. nolvdonor. specific artti-HLA antibodies on graft survival, many, researchers emphasized the effect of non-HLA antibodies (e.g.; anti-MICA antibodies); auto-antibodies (e.g.; anti-vimentin antibodies), allo-nephrectömy and combined liver-kidney transplantations on rejection processes. Beyond all these, a newly developed computer algorithm, 'HLAMatchmaker' has changed the concept of transplantation possibility in highly sensitized patients.

Anahtar Kelimeler

HLA Antigens Nephrectomy Kidney Transplantation Reoperation

Kaynakça

  • 1.Morris PJ, Mickey MR, Singal DP, Terasaki PI. Serotyping for homotransplantations. XXII. Specificity of cytotoxic antibodies developing after renal transplantation. Br Med J. 1969;l:758-759
  • 2.Jeannet M, Pinn VW, Flax MH, Russell PS. Humoral antibodies in renal alotransplantation in man. N Engl J Med. 1970;282:111-117
  • 3.McKenna RM, Takemoto SK, Terasaki PI. Anti-HLA antibodies after solid organ transplantation. Transplantation. 2000;69:319-326
  • 4.Terasaki P. Humoral theory of transplantation. Am J Transplant. 2003;3:665-673
  • 5.Kaufman A, de Souza Pontes LF, Queiroz Marques MT. Analysis of AHG-PRA and ELISA-PRA in kidney transplant patients with acute rejection episodes. Transplant Immunol. 2003;ll:175-178
  • 6.Crespo M, Lozano M, Sole M. Diagnosis and treatment of acute humoral rejection after kidney transplantation: preliminary experience. Transplant Proc. 2003;35:1677-1678
  • 7.Fernandez-Fresnedo G, Pastor JM, Lopez-Hoyos M. Relationship of donor-specific class-I anti-HLA antibodies detected by ELISA after kidney transplantation on the development of acute rejection and graft survival. Nephrol Dial Transplant 2003; 18:990-995
  • 8.Pelletier RP, Hennessy PK, Adams PW, VanBuskirk AM, Ferguson RM, Orosz CG. Clinical significance of MHC-reactive alloantibodies that develop after kidney or kidney-pancreas transplantation. Am J Transplant. 2002;2:134-141
  • 9.Panigrahi A, Deka R, Bhowmik D, Tiwari SC, Mehra NK. Immunological monitoring of posttransplant allograft sensitization following living related donor renal transplantation. Transplant Proc. 2004;36:1336-1339
  • lO.Crespo M, Pascual M, Tolkoff-Rubin Nal. Acute humoral rejection in renal allograft recipients: I.Incidence, serology and clinical characteristics. Transplantation. 2001:71:652-658
  • ll.Varnavidou-Nicolaidou A, Doxiadis II, Iniotaki-Theodoraki A, Patargias T, Stavropoulos-Giokas C, Kyriakides GK. HLA class I donor-specific triplet antibodies detected after renal transplantation. Transplant Proc. 2004;36:1732-1734
  • 12.Hourmant M, Cesbron-Gautier A, Terasaki P. Frequency and clinical implication of development of donor-specific and non-donor specific HLA antibodies after kidney transplantation. J Am Soc Nephrol. 2005; 16:2804-2812
  • 13.Sumitran-Holgersson S. HLA-specific alloantibodies and renal graft outcome. Nephrol Dial Transplant. 2001; 16:897-904
  • 14.Class FHJ and van Roood JJ. The hyperimmunized patient: from sensitziation toward transplantation. Transplant International. 1988; 1:53-57
  • 15.Palmer A, Taube D, Welsh K, Bewick M, Gjorstrup P, Thick M.Removal of anti-HLA antibodies by extracorporeal immunoadsorption to enable renal transplantation. Lancet. 1989; 1:10-12
  • 16.Hakim RM, Milford E, Himmelfarb J, Wingard R, Lazarus JM, Watt RM Extracorporeal removal of anti-HLA antibodies in transplant candidates. Am J Kidney Dis. 1990;16:423-431
  • 17.Lorenz M, Regele H, Schillinger M. Peritransplant immunoadsorption: a strategy enabling transplantation in highly sensitized crossmatch-positive cadaveric kidney allograft recipients. Transplantation. 2005;79:696-701
  • 18.Akalin E, Ames S, Sehgal V, Murphy B, Bromberg JS, Fotino M, Friedlander R. Intravenous immunoglobulin and thymoglobulin induction treatment in immunologically high-risk kidney transplant recipients. Transplantation. 2005;79:742
  • 19.Akalin E, Sehgal V, Murphy B. Intravenous assessment for antibody-mediated rejection and desensitization protocols. Transplantation. 2004;78:181-185
  • 20.Glotz D, Antoine C, Duboust A: Antidonor antibodies and transplantation: how to deal with them before and after transplantation. Transplantation. 2005;79:30-32
  • 21.Olausson M, Mjornstedt L, Norden G. Auxiliary liver and combined kidney transplantation prevents hyperacute kidney rejection in highly sensitized patients. Transplant Proc. 2002;34:3106-3107
  • 22.Gutierrez A, Crespo M, Mila J, Torregrosa JV, Martorell J, Oppenheimer F. Outcome of simultaneous liver-kidney transplantation in highly sensitized, crossmatch-positive patients. Transplant Proc. 2003;35:1861-1862
  • 23.Bjorkman PJ, Saper MA, Samraoui B, Bennet WS, Strominger Jl and Wiley DC. Structure of the human class I histocompatibility antigen, HLA-A2. Nature. 1987;329:506-512
  • 24.Rodey GE, Revels K, Fuller TC. Epitope specificity of HLA class I alloantibodies: II. Stability of cross-reactive group antibody patterns over extended time periods. Transplantation. 1997; 63:885-893. 25.Rodey GE, Neylan JF, Whelchel JD, Revels KW, Bray RA.Epitope specificity of HLA class I alloantibodies. Lfrequency analysis of to private versus public specificities in potential transplant recipients. Human Immunol. 1994;39:272-280
  • 26.1dica A, Sasaki N, Hardy S and Terasaki PI. Unexpected frequencies of HLA antibody specifities present in sera of multitransfused patients. In TERASAKI PI,eds. Clinical Transplants. California: Terasaki Foundation Laboratory. 2006:139-160
  • 27.Mao Q, Terasaki PI, Cai J, El -Awar N and Rebellato L. Analysis of HLA class I-specific antibodies in patients wiht failed allografs. Transplantation. 2007;83:54-61
  • 28.Cai J, Terasaki PI, Mao Q, Pham T. Development of non-donor specific HLA-Dr antibodies in allograft recipients is associated with shared epiotopes with mismatched donor DR antigens. Am J Transplant. 2006;6:2947-2954
  • 29.Duquesnoy RJ. A structurally based approach to determine HLA compatibility at the humoral immune level. Human Immunol. 2006;67:847-862
  • 3O.Adeyi OA, Girnita AL, Howe J. Serum analysis after transplant nephrectomy reveals restricted antibody specificity patterns against structurally defined HLA class I mismatches. Transpl Immunol. 2005; 14:53-62
  • 31.Harmer AW, Koffman CG, Heads AJ, Vaughan RW. Sensitization to HLA antigens occurs in 95% of primary renal transplant rejections. Transplant Proc. 1995;27:666-667
  • 32.Lee PC, Terasaki PI, Takemoto SK. All chronic rejection failures of kidney transplants were preceded by the development of HLA antibodies. Transplantation. 2002;74:1192-1194
  • 33.EI-Awar N, Terasaki PI, Lazda V, Nikaein A, Manning C, Armold AN. Almost all patients who are waiting for a regraft of a kidney transplant have anti HLA antibodies. Transplant Proc. 2002;34:2531-2532
  • 34.Worthington JE, Martin S, Dyer PA, Jahson RWG. An association between posttransplant antibody production and renal transplant rejection. Transplant Proc. 2001;33:475-476
  • 35.Zou Y, Mirbaha F, Lazaro A, Zhang Y, Lavingia B, Stastny P. MICA is a target for complement-dependent cytotoxicity with mouse monoclonal antibodies and human alloantibodies. Hum Immunol. 2002;63:30-39
  • 36.Hankey KG, Drachenberg CB, Papadimitriou JC. MIC expression in renal and pancreatic allografts. Transplantation. 2002;73:304-306
  • 37.Zwirner NW, Marcos CY, Mirbaha F, Zou Y, Stastny P. Identification of MICA as a new polymorphic alloantigen recognized by antibodies in sera of organ transplant recipients. Hum Immunol. 2000;61:917-924
  • 38.0guz F, Karahan G, Ozdilli K, Carin M. MHC and MIC genes in Autoimmunity. Turk J Immunol. 2005; 10:1-7
  • 39.Smith JD, Rose M. Detection and clinical relevance of antibodies after. Transplantation. 2006;333:227-246
  • 40.Mahesh B, Leong HS, McCormack A, Sarathchandra P, Holder A, and Rose ML. Autoantibodies to Vimentin Cause Accelerated Rejection of Cardiac Allografts. Am J Patho. 2007; 170:1415-1427
  • 41.Feucht HE. Complement C4d in graft capillaries—the missing link in the recognition of humoral alloreactivity. Am J Transplant. 2003;3:646-652
  • 42.Mohanakumar T, Waldrep JC, Phibbs M, Mendez-Picon G, Kaplan AM, Lee HM. Serological characterization of antibodies eluted from chronically rejected human renal allografts. Transplantation. 1981;32:61-66
  • 43.Morris PJ, Williams GM, Hume D, Mickey MR, Terasaki PI. Serotyping for homotransplantation: XII. Occurrence of cytotoxicantibodies following kidney transplantation in man. Transplantation. 1968;6:392-399
  • 44.Lepage V, Gluckman JC, Bedrossian J, Duboust A, Nebout T, Bracq C. Anti-B cell lymphocytotoxic antibodies in kidney transplant recipients. Transplantation. 1978;25:255-258
  • 45.Mohanakumar T, Rhodes C, Mendez-Picon G, Goldman M, Lee H. Renal allograft rejection associated with presensitization to HLA-DR antigens. Transplantation. 1981;31:93-95
  • 46.Martin L, Guignier F, Mousson C, Rageot D, Justrabo E, Rifle G. Detection of donor-specific anti-HLA antibodies with flow cytometry in eluates and sera from renal transplant recipients with chronic allograft nephropathy. Transplantation. 2003;76:395-400
  • 47,Leichtman A, Bragg-Gresham J. Final Report for Data Request from the Histocompatibility Committee Meeting of May 2002. UNOS Policy Proposal 7/17/02 2002: Appendix H4
  • 48.Suciu-Foca N, Rohowsky-Kochan C, Reed E. Idiotypic network regulations of immune responses to HLA. Fed Proc. 1985;44:2483-2487
  • 49.Claas FHJ, Witvliet M, Duquesnoy RJ, Persijn G, Doxiadis UN. The acceptable mismatch program as a fast tool to transplant highly sensitized patients awaiting a post-mortal kidney: short waiting time and excellent graft outcome. Transplantation. 2004;78:190-193

Renal re-transplantasyona hazırlanan hastaların anti-HLA antikor durumları ile ilgili yaklaşımlar

Yıl 2009, Cilt: 15 Sayı: 3, 36 - 41, 01.04.2009

Gonca Emel Karahan Fatma Sevcan Oğuz Mahmut N. Çarin

Öz

Bu derleme, renal re-transplantasyoha hazırlanan hastalarda anti-HLA antikor gelişim metonizmatarına^daklahmaktadır. Bu antikorların nakil öncesi dönemde var olması veya nakil spnrası de noyo üretj'mteri yıllar içerisinde graft yetmezliği ile sonlanır. Dönore özgü olan,ya da olmayan bu anti-HLA antikorların graft sağkalımı üzerine olan hasarlayıcı etkilerine ek olarak, pek çok çalışmada HLA dışı antikorlar (örn; anti-MICA antikorları), oto-antikorlar, allo-nefrektomi ve karaciğer ve böbreğin birlikte naklinin rejeksiyon süreçlerine etkilerini incelenmiştir.,Bunların yanı sıra, son yıllarda geliştirilen ve 'HLAMatchmaker' olarak adlandırılan bir bilgisayar algoritması, bekleme listelerinde uzun yıllar bekleyen ve nakil olma ihtimalleri çok düşük olan yüksek oranda sensitize bireyler için umut ışığı olma özelliğindedir.

Anahtar Kelimeler

HLA antijenleri Nefrektomi Böbrek nakli Reoperasyon

Kaynakça

  • 1.Morris PJ, Mickey MR, Singal DP, Terasaki PI. Serotyping for homotransplantations. XXII. Specificity of cytotoxic antibodies developing after renal transplantation. Br Med J. 1969;l:758-759
  • 2.Jeannet M, Pinn VW, Flax MH, Russell PS. Humoral antibodies in renal alotransplantation in man. N Engl J Med. 1970;282:111-117
  • 3.McKenna RM, Takemoto SK, Terasaki PI. Anti-HLA antibodies after solid organ transplantation. Transplantation. 2000;69:319-326
  • 4.Terasaki P. Humoral theory of transplantation. Am J Transplant. 2003;3:665-673
  • 5.Kaufman A, de Souza Pontes LF, Queiroz Marques MT. Analysis of AHG-PRA and ELISA-PRA in kidney transplant patients with acute rejection episodes. Transplant Immunol. 2003;ll:175-178
  • 6.Crespo M, Lozano M, Sole M. Diagnosis and treatment of acute humoral rejection after kidney transplantation: preliminary experience. Transplant Proc. 2003;35:1677-1678
  • 7.Fernandez-Fresnedo G, Pastor JM, Lopez-Hoyos M. Relationship of donor-specific class-I anti-HLA antibodies detected by ELISA after kidney transplantation on the development of acute rejection and graft survival. Nephrol Dial Transplant 2003; 18:990-995
  • 8.Pelletier RP, Hennessy PK, Adams PW, VanBuskirk AM, Ferguson RM, Orosz CG. Clinical significance of MHC-reactive alloantibodies that develop after kidney or kidney-pancreas transplantation. Am J Transplant. 2002;2:134-141
  • 9.Panigrahi A, Deka R, Bhowmik D, Tiwari SC, Mehra NK. Immunological monitoring of posttransplant allograft sensitization following living related donor renal transplantation. Transplant Proc. 2004;36:1336-1339
  • lO.Crespo M, Pascual M, Tolkoff-Rubin Nal. Acute humoral rejection in renal allograft recipients: I.Incidence, serology and clinical characteristics. Transplantation. 2001:71:652-658
  • ll.Varnavidou-Nicolaidou A, Doxiadis II, Iniotaki-Theodoraki A, Patargias T, Stavropoulos-Giokas C, Kyriakides GK. HLA class I donor-specific triplet antibodies detected after renal transplantation. Transplant Proc. 2004;36:1732-1734
  • 12.Hourmant M, Cesbron-Gautier A, Terasaki P. Frequency and clinical implication of development of donor-specific and non-donor specific HLA antibodies after kidney transplantation. J Am Soc Nephrol. 2005; 16:2804-2812
  • 13.Sumitran-Holgersson S. HLA-specific alloantibodies and renal graft outcome. Nephrol Dial Transplant. 2001; 16:897-904
  • 14.Class FHJ and van Roood JJ. The hyperimmunized patient: from sensitziation toward transplantation. Transplant International. 1988; 1:53-57
  • 15.Palmer A, Taube D, Welsh K, Bewick M, Gjorstrup P, Thick M.Removal of anti-HLA antibodies by extracorporeal immunoadsorption to enable renal transplantation. Lancet. 1989; 1:10-12
  • 16.Hakim RM, Milford E, Himmelfarb J, Wingard R, Lazarus JM, Watt RM Extracorporeal removal of anti-HLA antibodies in transplant candidates. Am J Kidney Dis. 1990;16:423-431
  • 17.Lorenz M, Regele H, Schillinger M. Peritransplant immunoadsorption: a strategy enabling transplantation in highly sensitized crossmatch-positive cadaveric kidney allograft recipients. Transplantation. 2005;79:696-701
  • 18.Akalin E, Ames S, Sehgal V, Murphy B, Bromberg JS, Fotino M, Friedlander R. Intravenous immunoglobulin and thymoglobulin induction treatment in immunologically high-risk kidney transplant recipients. Transplantation. 2005;79:742
  • 19.Akalin E, Sehgal V, Murphy B. Intravenous assessment for antibody-mediated rejection and desensitization protocols. Transplantation. 2004;78:181-185
  • 20.Glotz D, Antoine C, Duboust A: Antidonor antibodies and transplantation: how to deal with them before and after transplantation. Transplantation. 2005;79:30-32
  • 21.Olausson M, Mjornstedt L, Norden G. Auxiliary liver and combined kidney transplantation prevents hyperacute kidney rejection in highly sensitized patients. Transplant Proc. 2002;34:3106-3107
  • 22.Gutierrez A, Crespo M, Mila J, Torregrosa JV, Martorell J, Oppenheimer F. Outcome of simultaneous liver-kidney transplantation in highly sensitized, crossmatch-positive patients. Transplant Proc. 2003;35:1861-1862
  • 23.Bjorkman PJ, Saper MA, Samraoui B, Bennet WS, Strominger Jl and Wiley DC. Structure of the human class I histocompatibility antigen, HLA-A2. Nature. 1987;329:506-512
  • 24.Rodey GE, Revels K, Fuller TC. Epitope specificity of HLA class I alloantibodies: II. Stability of cross-reactive group antibody patterns over extended time periods. Transplantation. 1997; 63:885-893. 25.Rodey GE, Neylan JF, Whelchel JD, Revels KW, Bray RA.Epitope specificity of HLA class I alloantibodies. Lfrequency analysis of to private versus public specificities in potential transplant recipients. Human Immunol. 1994;39:272-280
  • 26.1dica A, Sasaki N, Hardy S and Terasaki PI. Unexpected frequencies of HLA antibody specifities present in sera of multitransfused patients. In TERASAKI PI,eds. Clinical Transplants. California: Terasaki Foundation Laboratory. 2006:139-160
  • 27.Mao Q, Terasaki PI, Cai J, El -Awar N and Rebellato L. Analysis of HLA class I-specific antibodies in patients wiht failed allografs. Transplantation. 2007;83:54-61
  • 28.Cai J, Terasaki PI, Mao Q, Pham T. Development of non-donor specific HLA-Dr antibodies in allograft recipients is associated with shared epiotopes with mismatched donor DR antigens. Am J Transplant. 2006;6:2947-2954
  • 29.Duquesnoy RJ. A structurally based approach to determine HLA compatibility at the humoral immune level. Human Immunol. 2006;67:847-862
  • 3O.Adeyi OA, Girnita AL, Howe J. Serum analysis after transplant nephrectomy reveals restricted antibody specificity patterns against structurally defined HLA class I mismatches. Transpl Immunol. 2005; 14:53-62
  • 31.Harmer AW, Koffman CG, Heads AJ, Vaughan RW. Sensitization to HLA antigens occurs in 95% of primary renal transplant rejections. Transplant Proc. 1995;27:666-667
  • 32.Lee PC, Terasaki PI, Takemoto SK. All chronic rejection failures of kidney transplants were preceded by the development of HLA antibodies. Transplantation. 2002;74:1192-1194
  • 33.EI-Awar N, Terasaki PI, Lazda V, Nikaein A, Manning C, Armold AN. Almost all patients who are waiting for a regraft of a kidney transplant have anti HLA antibodies. Transplant Proc. 2002;34:2531-2532
  • 34.Worthington JE, Martin S, Dyer PA, Jahson RWG. An association between posttransplant antibody production and renal transplant rejection. Transplant Proc. 2001;33:475-476
  • 35.Zou Y, Mirbaha F, Lazaro A, Zhang Y, Lavingia B, Stastny P. MICA is a target for complement-dependent cytotoxicity with mouse monoclonal antibodies and human alloantibodies. Hum Immunol. 2002;63:30-39
  • 36.Hankey KG, Drachenberg CB, Papadimitriou JC. MIC expression in renal and pancreatic allografts. Transplantation. 2002;73:304-306
  • 37.Zwirner NW, Marcos CY, Mirbaha F, Zou Y, Stastny P. Identification of MICA as a new polymorphic alloantigen recognized by antibodies in sera of organ transplant recipients. Hum Immunol. 2000;61:917-924
  • 38.0guz F, Karahan G, Ozdilli K, Carin M. MHC and MIC genes in Autoimmunity. Turk J Immunol. 2005; 10:1-7
  • 39.Smith JD, Rose M. Detection and clinical relevance of antibodies after. Transplantation. 2006;333:227-246
  • 40.Mahesh B, Leong HS, McCormack A, Sarathchandra P, Holder A, and Rose ML. Autoantibodies to Vimentin Cause Accelerated Rejection of Cardiac Allografts. Am J Patho. 2007; 170:1415-1427
  • 41.Feucht HE. Complement C4d in graft capillaries—the missing link in the recognition of humoral alloreactivity. Am J Transplant. 2003;3:646-652
  • 42.Mohanakumar T, Waldrep JC, Phibbs M, Mendez-Picon G, Kaplan AM, Lee HM. Serological characterization of antibodies eluted from chronically rejected human renal allografts. Transplantation. 1981;32:61-66
  • 43.Morris PJ, Williams GM, Hume D, Mickey MR, Terasaki PI. Serotyping for homotransplantation: XII. Occurrence of cytotoxicantibodies following kidney transplantation in man. Transplantation. 1968;6:392-399
  • 44.Lepage V, Gluckman JC, Bedrossian J, Duboust A, Nebout T, Bracq C. Anti-B cell lymphocytotoxic antibodies in kidney transplant recipients. Transplantation. 1978;25:255-258
  • 45.Mohanakumar T, Rhodes C, Mendez-Picon G, Goldman M, Lee H. Renal allograft rejection associated with presensitization to HLA-DR antigens. Transplantation. 1981;31:93-95
  • 46.Martin L, Guignier F, Mousson C, Rageot D, Justrabo E, Rifle G. Detection of donor-specific anti-HLA antibodies with flow cytometry in eluates and sera from renal transplant recipients with chronic allograft nephropathy. Transplantation. 2003;76:395-400
  • 47,Leichtman A, Bragg-Gresham J. Final Report for Data Request from the Histocompatibility Committee Meeting of May 2002. UNOS Policy Proposal 7/17/02 2002: Appendix H4
  • 48.Suciu-Foca N, Rohowsky-Kochan C, Reed E. Idiotypic network regulations of immune responses to HLA. Fed Proc. 1985;44:2483-2487
  • 49.Claas FHJ, Witvliet M, Duquesnoy RJ, Persijn G, Doxiadis UN. The acceptable mismatch program as a fast tool to transplant highly sensitized patients awaiting a post-mortal kidney: short waiting time and excellent graft outcome. Transplantation. 2004;78:190-193
Toplam 48 adet kaynakça vardır.

Ayrıntılar

Birincil Dil Türkçe
Bölüm Makaleler
Yazarlar

Gonca Emel Karahan Bu kişi benim

Fatma Sevcan Oğuz Bu kişi benim

Mahmut N. Çarin Bu kişi benim

Yayımlanma Tarihi 1 Nisan 2009
Yayımlandığı Sayı Yıl 2009 Cilt: 15 Sayı: 3

Kaynak Göster

APA Karahan, G. E., Oğuz, F. S., & Çarin, M. N. (2009). Renal re-transplantasyona hazırlanan hastaların anti-HLA antikor durumları ile ilgili yaklaşımlar. Gaziantep Medical Journal, 15(3), 36-41.
AMA Karahan GE, Oğuz FS, Çarin MN. Renal re-transplantasyona hazırlanan hastaların anti-HLA antikor durumları ile ilgili yaklaşımlar. Gaziantep Medical Journal. Nisan 2009;15(3):36-41.
Chicago Karahan, Gonca Emel, Fatma Sevcan Oğuz, ve Mahmut N. Çarin. “Renal Re-Transplantasyona hazırlanan hastaların Anti-HLA Antikor Durumları Ile Ilgili yaklaşımlar”. Gaziantep Medical Journal 15, sy. 3 (Nisan 2009): 36-41.
EndNote Karahan GE, Oğuz FS, Çarin MN (01 Nisan 2009) Renal re-transplantasyona hazırlanan hastaların anti-HLA antikor durumları ile ilgili yaklaşımlar. Gaziantep Medical Journal 15 3 36–41.
IEEE G. E. Karahan, F. S. Oğuz, ve M. N. Çarin, “Renal re-transplantasyona hazırlanan hastaların anti-HLA antikor durumları ile ilgili yaklaşımlar”, Gaziantep Medical Journal, c. 15, sy. 3, ss. 36–41, 2009.
ISNAD Karahan, Gonca Emel vd. “Renal Re-Transplantasyona hazırlanan hastaların Anti-HLA Antikor Durumları Ile Ilgili yaklaşımlar”. Gaziantep Medical Journal 15/3 (Nisan 2009), 36-41.
JAMA Karahan GE, Oğuz FS, Çarin MN. Renal re-transplantasyona hazırlanan hastaların anti-HLA antikor durumları ile ilgili yaklaşımlar. Gaziantep Medical Journal. 2009;15:36–41.
MLA Karahan, Gonca Emel vd. “Renal Re-Transplantasyona hazırlanan hastaların Anti-HLA Antikor Durumları Ile Ilgili yaklaşımlar”. Gaziantep Medical Journal, c. 15, sy. 3, 2009, ss. 36-41.
Vancouver Karahan GE, Oğuz FS, Çarin MN. Renal re-transplantasyona hazırlanan hastaların anti-HLA antikor durumları ile ilgili yaklaşımlar. Gaziantep Medical Journal. 2009;15(3):36-41.