Navigation Links
Scientists Spot Key to Kidney Transplant Success
Date:9/26/2007

A tough-to-detect antibody explains why even 'matched' organs get rejected

WEDNESDAY, Sept. 26 (HealthDay News) -- Researchers say a newly discovered immune factor is associated with kidney-transplant rejections and may explain why otherwise well-matched organs end up being rejected.

"Our paper showed that if a patient has this MICA antibody, that is very dangerous," said Dr. Yizhou Zou, study lead author and assistant professor of internal medicine at the University of Texas Southwestern Medical Center at Dallas.

"Current tests cannot see this antibody, so, this suggests that it may be very useful to add antibody screening to current screening tests," he noted.

The study is published in the Sept. 27 issue of the New England Journal of Medicine.

According to the U.S. National Institutes of Health, more than 9,000 kidney transplants are performed in the United States each year, making it second only to corneal transplants as the most common transplant operation.

More than 73,000 people are on the waiting list for a kidney, making successful transplantation critical.

However, for a kidney transplant to have even a hint of success, the donor and the recipient must be compatible. Donors and recipients can be incompatible in two ways: because of a blood type incompatibility or because of human leukocyte antigens (HLA) antigen sensitization.

HLAs, which are found on the surface of nearly every cell in the human body, help tell the difference between normal body tissue and foreign substances. Antigens vary from person to person, and HLA typing helps determine how many antigens a donor shares with a recipient. If individuals are not HLA matches, the recipient may produce antibodies to the antigen, thus spurring organ rejection.

But even donor-recipient pairs who are HLA matches can end in rejection. That has suggested that other -- as yet unknown -- antigens might be involved.

"The question was why is there a rejection, when the donor and recipient were an HLA match?" Zou said.

Major-histocompatibility-complex class I-related chain A (MICA) antigens can also stimulate antibody production and, the authors hypothesized, they might also contribute to organ rejection. The MICA antigen is found on endothelial cells, or the layer of cells lining the inside of blood vessels.

The trouble is, MICA antigens can't be detected with the methods normally used.

"Normal tests cannot see this antibody, so, we started to investigate this antibody, [to see] whether it was involved in kidney transplant rejection," Zou said.

Zou's group had previously identified MICA antibodies in transplant recipients, so they developed a test to screen for the antibody.

For this study, Zou and his colleagues tested blood samples from 1,910 recipients of kidney transplants from deceased donors, looking for anti-MICA antibodies. The blood samples came from the University of Heidelberg in Germany, which keeps a large database on transplant donors and recipients.

Antibodies against MICA were detected in 11.4 percent of the patients. The presence of these antibodies was also associated with rejection of the new kidney.

The rate of transplanted organ survival over a year for recipients with anti-MICA antibodies was 88.3 percent, versus 93 percent for those without the antibodies.

Among first-time recipients of a kidney, the organ survival rate was even lower among those with antibodies (87.8 percent) than those without antibodies (93.5 percent).

And among those with good HLA matching, having anti-MICA antibodies was associated with poorer organ survival (83.2 percent versus 95.1 percent among those without the antibodies).

"There was a very strong positive association with the MICA antibody and rejection," Zou said. "That was a surprise for us."

It's not clear yet that the anti-MICA antibody causes the organ rejection, but these findings strongly suggest that this is the case.

According to an accompanying editorial, "HLA remains the cornerstone of transplantation immunology." However, detection of MICA antigens and their corresponding antibodies may represent "a new tool set for understanding the rejection of kidney transplants," the editorial authors wrote.

"I think this is definitely a potentially useful tool in monitoring patients for increased risk of rejection," said Dr. Mohanram Narayanan, assistant professor of internal medicine with the Texas A&M Health Science Center College of Medicine and chief of the Section of Clinical Transplantation for Scott & White. After standard blood and HLA typing, "this would be a third thing to look at to make sure they're not at risk for rejection," he said.

The practice probably will not become routine right away, however, Narayanan added.

"We don't quite understand how people develop antibodies, so this is a good test on paper, but we don't really know who are the people who are at risk of developing antibodies," he said. "We need to do more studies to show what are the potential factors that cause patients to develop antibodies. It's something that you probably should look at, but I think we still have a lot more to understand about how it occurs."

More information

Read more about organ transplantation at the United Network for Organ Sharing.



SOURCES: Yizhou Zou, M.D., assistant professor, internal medicine, University of Texas Southwestern Medical Center at Dallas; Mohanram Narayanan, M.D., assistant professor of internal medicine, Texas A&M Health Science Center College of Medicine, and chief, section of clinical transplantation, Scott & White; Sept. 27, 2007, New England Journal of Medicine


'/>"/>
Copyright©2007 ScoutNews,LLC.
All rights reserved

Related medicine news :

1. Nobel Prize for Medicine shared by Three scientists
2. Scientists plan human cloning clinic in the United States
3. Scientists crack mechanism of Leptin-Obesity Hormone
4. Scientists use plant hormones to fight cancer
5. American scientists alter gene makeup of babies
6. Expose on eating disorders!! Scientists trace “brain’s eating control center pathway”
7. Scientists found ancient Human Germ Killer
8. Scientists locate key hormone involved in appetite control
9. Scientists open the book of life
10. Electronic nose by Italian scientists
11. Scientists review SARS
Post Your Comments:
*Name:
*Comment:
*Email:
(Date:6/26/2016)... , ... June 26, 2016 , ... Brent Kasmer, a legally blind and certified personal ... personalized through a fitness app. The fitness app plans to fix the two major problems ... offer a one size fits all type program , They don’t eliminate all ...
(Date:6/25/2016)... ... ... Austin residents seeking Mohs surgery services, can now turn to Dr. Jessica Scruggs ... for medical and surgical dermatology. , Dr. Dorsey brings specialization to include Mohs surgery, ... Micrographic Surgery completed by Dr. Dorsey was under the direction of Glenn Goldstein, MD, ...
(Date:6/25/2016)... ... June 25, 2016 , ... First Choice Emergency Room , the ... Ogunleye, as the Medical Director of its new Mesquite-Samuell Farm facility. , “We ... new Mesquite location,” said Dr. James M. Muzzarelli, Executive Medical Director of First Choice ...
(Date:6/25/2016)... ... 25, 2016 , ... On Friday, June 10, Van Mitchell, Secretary of the ... to iHire in recognition of their exemplary accomplishments in worksite health promotion. , The ... Health & Wellness Symposium at the BWI Marriott in Linthicum Heights. iHire was one ...
(Date:6/24/2016)... ... June 24, 2016 , ... Those who have experienced traumatic events may suffer ... unhealthy avenues, such as drug or alcohol abuse, as a coping mechanism. To avoid ... healthy coping following a traumatic event. , Trauma sufferers tend to feel a range ...
Breaking Medicine News(10 mins):
(Date:6/23/2016)... , June 23, 2016 Any dentist who ... challenges of the current process. Many of them do not ... the technical difficulties and high laboratory costs involved. And those ... offer it at such a high cost that the majority ... Dr. Parsa Zadeh , founder of Dental ...
(Date:6/23/2016)... , June 23, 2016 ... CAPR ), a biotechnology company focused on ... today announced that patient enrollment in its ongoing ... Duchenne) has exceeded 50% of its 24-patient target. ... in the third quarter of 2016, and to ...
(Date:6/23/2016)... 23, 2016  Astellas today announced the establishment of Astellas Farma Colombia (AFC), a new affiliate with operations headquartered ... Latin America . ... ... ... ...
Breaking Medicine Technology: