Antibody-Mediated Rejection and Sponge Effect in a Redo Lung Transplant Recipient
Long-term survival after lung transplant remains severely limited by chronic lung allograft dysfunction. Antibody-mediated rejection of lung transplant allografts is usually caused by donor-specific antibodies (DSAs) directed toward donor human leukocyte antigens (HLAs). Typically, patients with ant...
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| Format: | Article |
| Language: | English |
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Wiley
2021-01-01
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| Series: | Case Reports in Transplantation |
| Online Access: | http://dx.doi.org/10.1155/2021/6637154 |
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| author | Ashwini Arjuna Michael T. Olson Sofya Tokman Rajat Walia Thalachallour Mohanakumar A. Samad Hashimi Michael A. Smith Ross M. Bremner Ashraf Omar |
| author_facet | Ashwini Arjuna Michael T. Olson Sofya Tokman Rajat Walia Thalachallour Mohanakumar A. Samad Hashimi Michael A. Smith Ross M. Bremner Ashraf Omar |
| author_sort | Ashwini Arjuna |
| collection | DOAJ |
| description | Long-term survival after lung transplant remains severely limited by chronic lung allograft dysfunction. Antibody-mediated rejection of lung transplant allografts is usually caused by donor-specific antibodies (DSAs) directed toward donor human leukocyte antigens (HLAs). Typically, patients with antibody-mediated rejection have significantly higher circulating DSAs and increased mean fluorescence intensity than those without antibody-mediated rejection. However, some patients with antibody-mediated rejection have low mean fluorescence intensities, partly due to the “sponge effect” related to DSAs binding to HLA molecules within the lung. Herein, we report the case of an 18-year-old, female lung transplant recipient who required retransplantation and developed circulating DSAs directed toward the first allograft but detected in circulation only after retransplantation. The present case draws attention to a rare finding of sponge effect in a patient with antibody-mediated rejection leading to allograft failure. |
| format | Article |
| id | doaj-art-d72db6de55f944edb2095632244ee433 |
| institution | Kabale University |
| issn | 2090-6943 2090-6951 |
| language | English |
| publishDate | 2021-01-01 |
| publisher | Wiley |
| record_format | Article |
| series | Case Reports in Transplantation |
| spelling | doaj-art-d72db6de55f944edb2095632244ee4332025-02-03T01:24:43ZengWileyCase Reports in Transplantation2090-69432090-69512021-01-01202110.1155/2021/66371546637154Antibody-Mediated Rejection and Sponge Effect in a Redo Lung Transplant RecipientAshwini Arjuna0Michael T. Olson1Sofya Tokman2Rajat Walia3Thalachallour Mohanakumar4A. Samad Hashimi5Michael A. Smith6Ross M. Bremner7Ashraf Omar8Norton Thoracic Institute, St. Joseph’s Hospital and Medical Center, 500 W. Thomas Road, Ste. 500; Phoenix, AZ 85013, USANorton Thoracic Institute, St. Joseph’s Hospital and Medical Center, 500 W. Thomas Road, Ste. 500; Phoenix, AZ 85013, USANorton Thoracic Institute, St. Joseph’s Hospital and Medical Center, 500 W. Thomas Road, Ste. 500; Phoenix, AZ 85013, USANorton Thoracic Institute, St. Joseph’s Hospital and Medical Center, 500 W. Thomas Road, Ste. 500; Phoenix, AZ 85013, USANorton Thoracic Institute Research Laboratory, St. Joseph’s Hospital and Medical Center, 500 W. Thomas Road, Ste. 500; Phoenix, AZ 85013, USANorton Thoracic Institute, St. Joseph’s Hospital and Medical Center, 500 W. Thomas Road, Ste. 500; Phoenix, AZ 85013, USANorton Thoracic Institute, St. Joseph’s Hospital and Medical Center, 500 W. Thomas Road, Ste. 500; Phoenix, AZ 85013, USANorton Thoracic Institute, St. Joseph’s Hospital and Medical Center, 500 W. Thomas Road, Ste. 500; Phoenix, AZ 85013, USANorton Thoracic Institute, St. Joseph’s Hospital and Medical Center, 500 W. Thomas Road, Ste. 500; Phoenix, AZ 85013, USALong-term survival after lung transplant remains severely limited by chronic lung allograft dysfunction. Antibody-mediated rejection of lung transplant allografts is usually caused by donor-specific antibodies (DSAs) directed toward donor human leukocyte antigens (HLAs). Typically, patients with antibody-mediated rejection have significantly higher circulating DSAs and increased mean fluorescence intensity than those without antibody-mediated rejection. However, some patients with antibody-mediated rejection have low mean fluorescence intensities, partly due to the “sponge effect” related to DSAs binding to HLA molecules within the lung. Herein, we report the case of an 18-year-old, female lung transplant recipient who required retransplantation and developed circulating DSAs directed toward the first allograft but detected in circulation only after retransplantation. The present case draws attention to a rare finding of sponge effect in a patient with antibody-mediated rejection leading to allograft failure.http://dx.doi.org/10.1155/2021/6637154 |
| spellingShingle | Ashwini Arjuna Michael T. Olson Sofya Tokman Rajat Walia Thalachallour Mohanakumar A. Samad Hashimi Michael A. Smith Ross M. Bremner Ashraf Omar Antibody-Mediated Rejection and Sponge Effect in a Redo Lung Transplant Recipient Case Reports in Transplantation |
| title | Antibody-Mediated Rejection and Sponge Effect in a Redo Lung Transplant Recipient |
| title_full | Antibody-Mediated Rejection and Sponge Effect in a Redo Lung Transplant Recipient |
| title_fullStr | Antibody-Mediated Rejection and Sponge Effect in a Redo Lung Transplant Recipient |
| title_full_unstemmed | Antibody-Mediated Rejection and Sponge Effect in a Redo Lung Transplant Recipient |
| title_short | Antibody-Mediated Rejection and Sponge Effect in a Redo Lung Transplant Recipient |
| title_sort | antibody mediated rejection and sponge effect in a redo lung transplant recipient |
| url | http://dx.doi.org/10.1155/2021/6637154 |
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