Transplant Immunology Laboratory, Comprehensive Transplant Center, Feinberg School of Medicine, Northwestern University, 303 E Chicago Avenue, Tarry Building, Suite 11-703, Chicago, IL 60611, USA; Department of Surgery, Comprehensive Transplant Center, Feinberg School of Medicine, Northwestern University, 251 East Huron Street, Galter 3-150, Chicago, IL 60611, USA.
Hum Immunol. 2013 Nov;74(11):1431-6. doi: 10.1016/j.humimm.2013.06.007. Epub 2013 Jun 15.
Anti-endothelial cell antibodies (AECAs) may play a role in allograft rejection. We prospectively tested 150 consecutive living donor kidney transplant recipients, with transplants performed at Northwestern Memorial Hospital between January and December 2010, using the donor-specific endothelial (XM-ONE) crossmatch. 88/150 Patients received standard of care (SOC) immunosuppression and analyzed separately, in addition to the complete study cohort. Patients were followed for one year and XM-ONE results were analyzed in relation to occurrence of acute rejection, proteinuria, serum creatinine levels, and biopsy proven fibrosis. No correlation was found between XM-ONE results and protocol or "for-cause" biopsy proven acute rejection or vasculopathy at 12 months. When IgG+ and IgM+ results of the XM-ONE assay were combined, a correlation with proteinuria at 12 months was observed (p=0.047). Although IgG+XM-ONE results were associated with significantly higher creatinine at 6 months (p=0.018), significance was lost at 12 months. Conversely, patients with an IgM+XM-ONE crossmatch had significantly lower creatinine at 1 month (p=0.019), 3 months (p=0.0045), and 6 months (p=0.038) post-transplant, but lost statistical significance at 12 months (p=0.67) post-transplant. In summary, the presence of AECAs as determined by a positive XM-ONE result was not predictive of overall poorer graft outcome after one year in our center.
抗内皮细胞抗体（AECA）可能在同种异体移植物排斥中起作用。我们前瞻性地检测了 150 名连续的活体供肾移植受者，这些受者于 2010 年 1 月至 12 月在西北纪念医院进行了移植，并使用了供体特异性内皮（XM-ONE）交叉匹配。88/150 名患者接受了标准的免疫抑制治疗（SOC），并分别进行了分析，除了完整的研究队列。患者随访了一年，分析了 XM-ONE 结果与急性排斥反应、蛋白尿、血清肌酐水平和活检证实的纤维化的关系。在 12 个月时，未发现 XM-ONE 结果与方案或“因原因”活检证实的急性排斥反应或血管病变之间存在相关性。当 XM-ONE 检测的 IgG+和 IgM+结果结合时，观察到与 12 个月时蛋白尿的相关性（p=0.047）。尽管 IgG+XM-ONE 结果与 6 个月时肌酐显著升高相关（p=0.018），但在 12 个月时失去了显著性。相反，IgM+XM-ONE 交叉匹配的患者在移植后 1 个月（p=0.019）、3 个月（p=0.0045）和 6 个月（p=0.038）时肌酐显著降低，但在移植后 12 个月时失去了统计学意义（p=0.67）。总之，在我们中心，通过 XM-ONE 阳性结果确定的 AECA 的存在不能预测一年后整体移植物结局较差。
