Repository for Antibody Incompatible Transplantation Evidence

Suppression of HLA-specific alloantibodies by high-dose intravenous immunoglobulins (IVIg). A potential tool for transplantation of immunized patients.

Transplantation. 1993 Aug;56(2):335-7 doi: 10.1097/00007890-199308000-00015.
Abstract

Renal transplantation in patients presenting end-stage renal failure can be hampered by the presence of alloantibodies against HLA antigens. In 4 out of 5 patients with HLA-specific alloantibodies waiting for a renal allograft, treatment with high-dose i.v. Ig resulted in a prolonged suppression (over 3 months) of most of the panel-reactive anti-HLA antibodies (PRA). Intravenous polyclonal human Ig (IVIg) and F(ab')2 fragments from IVIg inhibited the binding of patients' plasma and IgG fractions to peripheral blood lymphocytes from normal donors as well as their cytotoxicity, suggesting that the in vivo effect of IVIg was mediated by the presence, in the IVIg preparation, of anti-idiotypes directed against idiotypes borne on the anti-HLA antibodies. Thus, treatment with IVIg can be a valuable tool toward the transplantation of immunized patients.

Categorisation
LEVEL OF EVIDENCE: Case Report
LANGUAGE: English
ORGAN TYPE: Kidney
Metadata
MESH HEADINGS: Antibody Specificity; Antibody-Dependent Cell Cytotoxicity / drug effects; Dose-Response Relationship, Drug; Flow Cytometry; HLA Antigens / immunology*; Humans; Immunization*; Immunoglobulins, Intravenous / therapeutic use*; Immunosuppressive Agents / therapeutic use*; Isoantibodies / drug effects*; Isoantibodies / immunology*; Isoantibodies / metabolism; Kidney Failure, Chronic / blood; Kidney Failure, Chronic / immunology; Kidney Transplantation / immunology*; T-Lymphocytes / metabolism