Kidney transplantation in patients with preformed and exclusively anti-HLA-Cw donor specific antibody

We report a patient who had received a first kidney transplant and had preformed DSA anti-HLA-Cw, developing AMR C4d+ soon after transplant. Classically anti-HLA-Cw are considered less immunogenic and are not considered in many organ allocation systems or immunologic risk stratification algorithms, including in Portugal. However, data from literature confirms that their presence is as deleterious as DSA anti-HLA A/B/DR/DQ. Thus we should take HLA-C typing and respective antibody identification into account in sensitized patients, in order to access risk stratification and establish the need for correct induction or desensitization therapies

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Bibliographic Details
Main Authors: Santos,Sofia, Castro,Ana, Campos,Andreia, Pedroso,Sofia, Dias,Leonídio, Henriques,Castro
Format: Digital revista
Language:English
Published: Sociedade Portuguesa de Nefrologia 2017
Online Access:http://scielo.pt/scielo.php?script=sci_arttext&pid=S0872-01692017000100007
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Summary:We report a patient who had received a first kidney transplant and had preformed DSA anti-HLA-Cw, developing AMR C4d+ soon after transplant. Classically anti-HLA-Cw are considered less immunogenic and are not considered in many organ allocation systems or immunologic risk stratification algorithms, including in Portugal. However, data from literature confirms that their presence is as deleterious as DSA anti-HLA A/B/DR/DQ. Thus we should take HLA-C typing and respective antibody identification into account in sensitized patients, in order to access risk stratification and establish the need for correct induction or desensitization therapies