Correlation of ELISA-detected IgG and IgA anti-HLA antibodies in pretransplant sera with renal allograft rejection

Ronald H. Kerman, Brian Susskind, Roland Buelow, Jeffrey Regan, Philippe Pouletty, Jackie Williams, Kathy Gerolami, David H Kerman, Stephen M. Katz, Charles T. Van Buren, Barry D. Kahan

Research output: Contribution to journalArticle

65 Citations (Scopus)

Abstract

The present study compared the occurrence of rejection episodes during the first twelve posttransplant (Tx) months and the 1-, 2-, and 3-year graft survivals among recipients stratified by the percent panel reactive antibody (% PRA) of pre-Tx sera as detected using either an antihuman globulin determined PRA (AHG-% PRA) or an ELISA methodology detecting IgG reactive against soluble HLA class I antigens (% PRA-STAT). There was a significant correlation between AHG-PRA≤10% and a PRA-STAT≤10% (P<0.001). However, among 200 sera displaying an AHG-PRA≤10% (mean 57±21%), only 69% (138/200) displayed a PRA-STAT≤10%. With further study the discrepant finding, of 62 sera that were AHG-PRA≤10% but PRA-STAT <10%, was due to the presence of IgM and/or IgG non-MHC reactivity. In contrast, among 293 sera displaying an AHG- PRA <10% (mean 3±2%), 15% (43/293) displayed a PRA-STAT≤10%. There was no correlation between AHG-% PRA and rejection episodes occurring during the first twelve post Tx months. In contrast, however, there was a highly significant correlation between PRA-STAT≤10% and the occurrence of rejection episodes during the first twelve post-Tx months (P<0.001). Patients with PRA- STAT≤10% experienced a 70% rejection frequency compared with the 35% rejection frequency for patients with PRA-STAT sera < 10% (P<0.001). A significant correlation was observed between the presence of IgG-1 and rejection (P<0.01) but not IgG-subclasses 2, 3, or 4. Of particular interest was the observation in 11 patients that the presence of ELISA-detected IgA anti-HLA class I antigen (ELISA-IgA PRA≤10%) was associated with a significantly reduced rejection risk compared with sera where only PRA- STAT≤10% was present (27% vs. 70% incidence of rejection episodes, P<0.01). Finally, patients displaying pretransplant PRA-STAT results < 10% experienced significantly improved 1-, 2-, and 3- year graft survivals of 85% vs. 74%, 82% vs. 70% and 81% vs. 67%, respectively (P<0.01 for each time point), compared with patients displaying PRA-STAT results≤10%. These data suggest that the use of the ELISA methodology to detect IgG reactivity against soluble HLA class I antigens (PRA-STAT) may allow for the determination of a more clinically informative % PRA than the AHG-% PRA. Moreover, the presence of ELISA-detected IgA anti-HLA may act to inhibit rejection mechanisms associated with ELISA-detected IgG anti-HLA≤10%.

Original languageEnglish
Pages (from-to)201-205
Number of pages5
JournalTransplantation
Volume62
Issue number2
DOIs
StatePublished - Jul 27 1996
Externally publishedYes

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Immunoglobulin A
Allografts
Anti-Idiotypic Antibodies
Immunoglobulin G
Enzyme-Linked Immunosorbent Assay
Kidney
Histocompatibility Antigens Class I
Globulins
HLA Antigens
Serum
Graft Survival
Immunoglobulin M
Observation
Antibodies
Incidence
anti-IgA

ASJC Scopus subject areas

  • Transplantation
  • Immunology

Cite this

Kerman, R. H., Susskind, B., Buelow, R., Regan, J., Pouletty, P., Williams, J., ... Kahan, B. D. (1996). Correlation of ELISA-detected IgG and IgA anti-HLA antibodies in pretransplant sera with renal allograft rejection. Transplantation, 62(2), 201-205. https://doi.org/10.1097/00007890-199607270-00009

Correlation of ELISA-detected IgG and IgA anti-HLA antibodies in pretransplant sera with renal allograft rejection. / Kerman, Ronald H.; Susskind, Brian; Buelow, Roland; Regan, Jeffrey; Pouletty, Philippe; Williams, Jackie; Gerolami, Kathy; Kerman, David H; Katz, Stephen M.; Van Buren, Charles T.; Kahan, Barry D.

In: Transplantation, Vol. 62, No. 2, 27.07.1996, p. 201-205.

Research output: Contribution to journalArticle

Kerman, RH, Susskind, B, Buelow, R, Regan, J, Pouletty, P, Williams, J, Gerolami, K, Kerman, DH, Katz, SM, Van Buren, CT & Kahan, BD 1996, 'Correlation of ELISA-detected IgG and IgA anti-HLA antibodies in pretransplant sera with renal allograft rejection', Transplantation, vol. 62, no. 2, pp. 201-205. https://doi.org/10.1097/00007890-199607270-00009
Kerman, Ronald H. ; Susskind, Brian ; Buelow, Roland ; Regan, Jeffrey ; Pouletty, Philippe ; Williams, Jackie ; Gerolami, Kathy ; Kerman, David H ; Katz, Stephen M. ; Van Buren, Charles T. ; Kahan, Barry D. / Correlation of ELISA-detected IgG and IgA anti-HLA antibodies in pretransplant sera with renal allograft rejection. In: Transplantation. 1996 ; Vol. 62, No. 2. pp. 201-205.
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abstract = "The present study compared the occurrence of rejection episodes during the first twelve posttransplant (Tx) months and the 1-, 2-, and 3-year graft survivals among recipients stratified by the percent panel reactive antibody ({\%} PRA) of pre-Tx sera as detected using either an antihuman globulin determined PRA (AHG-{\%} PRA) or an ELISA methodology detecting IgG reactive against soluble HLA class I antigens ({\%} PRA-STAT). There was a significant correlation between AHG-PRA≤10{\%} and a PRA-STAT≤10{\%} (P<0.001). However, among 200 sera displaying an AHG-PRA≤10{\%} (mean 57±21{\%}), only 69{\%} (138/200) displayed a PRA-STAT≤10{\%}. With further study the discrepant finding, of 62 sera that were AHG-PRA≤10{\%} but PRA-STAT <10{\%}, was due to the presence of IgM and/or IgG non-MHC reactivity. In contrast, among 293 sera displaying an AHG- PRA <10{\%} (mean 3±2{\%}), 15{\%} (43/293) displayed a PRA-STAT≤10{\%}. There was no correlation between AHG-{\%} PRA and rejection episodes occurring during the first twelve post Tx months. In contrast, however, there was a highly significant correlation between PRA-STAT≤10{\%} and the occurrence of rejection episodes during the first twelve post-Tx months (P<0.001). Patients with PRA- STAT≤10{\%} experienced a 70{\%} rejection frequency compared with the 35{\%} rejection frequency for patients with PRA-STAT sera < 10{\%} (P<0.001). A significant correlation was observed between the presence of IgG-1 and rejection (P<0.01) but not IgG-subclasses 2, 3, or 4. Of particular interest was the observation in 11 patients that the presence of ELISA-detected IgA anti-HLA class I antigen (ELISA-IgA PRA≤10{\%}) was associated with a significantly reduced rejection risk compared with sera where only PRA- STAT≤10{\%} was present (27{\%} vs. 70{\%} incidence of rejection episodes, P<0.01). Finally, patients displaying pretransplant PRA-STAT results < 10{\%} experienced significantly improved 1-, 2-, and 3- year graft survivals of 85{\%} vs. 74{\%}, 82{\%} vs. 70{\%} and 81{\%} vs. 67{\%}, respectively (P<0.01 for each time point), compared with patients displaying PRA-STAT results≤10{\%}. These data suggest that the use of the ELISA methodology to detect IgG reactivity against soluble HLA class I antigens (PRA-STAT) may allow for the determination of a more clinically informative {\%} PRA than the AHG-{\%} PRA. Moreover, the presence of ELISA-detected IgA anti-HLA may act to inhibit rejection mechanisms associated with ELISA-detected IgG anti-HLA≤10{\%}.",
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AU - Kerman, Ronald H.

AU - Susskind, Brian

AU - Buelow, Roland

AU - Regan, Jeffrey

AU - Pouletty, Philippe

AU - Williams, Jackie

AU - Gerolami, Kathy

AU - Kerman, David H

AU - Katz, Stephen M.

AU - Van Buren, Charles T.

AU - Kahan, Barry D.

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N2 - The present study compared the occurrence of rejection episodes during the first twelve posttransplant (Tx) months and the 1-, 2-, and 3-year graft survivals among recipients stratified by the percent panel reactive antibody (% PRA) of pre-Tx sera as detected using either an antihuman globulin determined PRA (AHG-% PRA) or an ELISA methodology detecting IgG reactive against soluble HLA class I antigens (% PRA-STAT). There was a significant correlation between AHG-PRA≤10% and a PRA-STAT≤10% (P<0.001). However, among 200 sera displaying an AHG-PRA≤10% (mean 57±21%), only 69% (138/200) displayed a PRA-STAT≤10%. With further study the discrepant finding, of 62 sera that were AHG-PRA≤10% but PRA-STAT <10%, was due to the presence of IgM and/or IgG non-MHC reactivity. In contrast, among 293 sera displaying an AHG- PRA <10% (mean 3±2%), 15% (43/293) displayed a PRA-STAT≤10%. There was no correlation between AHG-% PRA and rejection episodes occurring during the first twelve post Tx months. In contrast, however, there was a highly significant correlation between PRA-STAT≤10% and the occurrence of rejection episodes during the first twelve post-Tx months (P<0.001). Patients with PRA- STAT≤10% experienced a 70% rejection frequency compared with the 35% rejection frequency for patients with PRA-STAT sera < 10% (P<0.001). A significant correlation was observed between the presence of IgG-1 and rejection (P<0.01) but not IgG-subclasses 2, 3, or 4. Of particular interest was the observation in 11 patients that the presence of ELISA-detected IgA anti-HLA class I antigen (ELISA-IgA PRA≤10%) was associated with a significantly reduced rejection risk compared with sera where only PRA- STAT≤10% was present (27% vs. 70% incidence of rejection episodes, P<0.01). Finally, patients displaying pretransplant PRA-STAT results < 10% experienced significantly improved 1-, 2-, and 3- year graft survivals of 85% vs. 74%, 82% vs. 70% and 81% vs. 67%, respectively (P<0.01 for each time point), compared with patients displaying PRA-STAT results≤10%. These data suggest that the use of the ELISA methodology to detect IgG reactivity against soluble HLA class I antigens (PRA-STAT) may allow for the determination of a more clinically informative % PRA than the AHG-% PRA. Moreover, the presence of ELISA-detected IgA anti-HLA may act to inhibit rejection mechanisms associated with ELISA-detected IgG anti-HLA≤10%.

AB - The present study compared the occurrence of rejection episodes during the first twelve posttransplant (Tx) months and the 1-, 2-, and 3-year graft survivals among recipients stratified by the percent panel reactive antibody (% PRA) of pre-Tx sera as detected using either an antihuman globulin determined PRA (AHG-% PRA) or an ELISA methodology detecting IgG reactive against soluble HLA class I antigens (% PRA-STAT). There was a significant correlation between AHG-PRA≤10% and a PRA-STAT≤10% (P<0.001). However, among 200 sera displaying an AHG-PRA≤10% (mean 57±21%), only 69% (138/200) displayed a PRA-STAT≤10%. With further study the discrepant finding, of 62 sera that were AHG-PRA≤10% but PRA-STAT <10%, was due to the presence of IgM and/or IgG non-MHC reactivity. In contrast, among 293 sera displaying an AHG- PRA <10% (mean 3±2%), 15% (43/293) displayed a PRA-STAT≤10%. There was no correlation between AHG-% PRA and rejection episodes occurring during the first twelve post Tx months. In contrast, however, there was a highly significant correlation between PRA-STAT≤10% and the occurrence of rejection episodes during the first twelve post-Tx months (P<0.001). Patients with PRA- STAT≤10% experienced a 70% rejection frequency compared with the 35% rejection frequency for patients with PRA-STAT sera < 10% (P<0.001). A significant correlation was observed between the presence of IgG-1 and rejection (P<0.01) but not IgG-subclasses 2, 3, or 4. Of particular interest was the observation in 11 patients that the presence of ELISA-detected IgA anti-HLA class I antigen (ELISA-IgA PRA≤10%) was associated with a significantly reduced rejection risk compared with sera where only PRA- STAT≤10% was present (27% vs. 70% incidence of rejection episodes, P<0.01). Finally, patients displaying pretransplant PRA-STAT results < 10% experienced significantly improved 1-, 2-, and 3- year graft survivals of 85% vs. 74%, 82% vs. 70% and 81% vs. 67%, respectively (P<0.01 for each time point), compared with patients displaying PRA-STAT results≤10%. These data suggest that the use of the ELISA methodology to detect IgG reactivity against soluble HLA class I antigens (PRA-STAT) may allow for the determination of a more clinically informative % PRA than the AHG-% PRA. Moreover, the presence of ELISA-detected IgA anti-HLA may act to inhibit rejection mechanisms associated with ELISA-detected IgG anti-HLA≤10%.

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