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Article ; Online: Crossmatch assays in transplantation: Physical or virtual?: A review.

Rocha, Yermis / Jaramillo, Andrés / Neumann, Jorge / Hacke, Katrin / Palou, Eduard / Torres, Juan

2023 Volume 102, Issue 50, Page(s) e36527

Abstract: The value of the crossmatch test in assessing pretransplant immunological risk is vital for clinical decisions, ranging from the indication of the transplant to the guidance of induction protocols and treatment with immunosuppressants. The crossmatch ... ...

Abstract	The value of the crossmatch test in assessing pretransplant immunological risk is vital for clinical decisions, ranging from the indication of the transplant to the guidance of induction protocols and treatment with immunosuppressants. The crossmatch tests in transplantation can be physical or virtual, each with its advantages and limitations. Currently, the virtual crossmatch stands out for its sensitivity and specificity compared to the physical tests. Additionally, the virtual crossmatch can be performed in less time, allowing for a reduction in cold ischemia time. It shows a good correlation with the results of physical tests and does not negatively impact graft survival. Proper communication between clinicians and the transplant immunology laboratory will lead to a deeper understanding of each patient's immunological profile, better donor-recipient selection, and improved graft survival.
MeSH term(s)	Humans ; Graft Rejection/diagnosis ; Graft Rejection/prevention & control ; Graft Survival ; Histocompatibility Testing/methods ; HLA Antigens ; Kidney Transplantation
Chemical Substances	HLA Antigens
Language	English
Publishing date	2023-12-19
Publishing country	United States
Document type	Review ; Journal Article
ZDB-ID	80184-7
ISSN	1536-5964 ; 0025-7974
ISSN (online)	1536-5964
ISSN	0025-7974
DOI	10.1097/MD.0000000000036527
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Article: Impact of SARS-CoV-2 Infection on Humoral and Cellular Immunity in a Cohort of Vaccinated Solid Organ Transplant Recipients.

Ayala-Borges, Bernardo / Escobedo, Miguel / Egri, Natalia / Herrera, Sabina / Crespo, Marta / Mirabet, Sonia / Arias-Cabrales, Carlos / Vilella, Anna / Palou, Eduard / Mosquera, María M / Pascal, Mariona / Colmenero, Jordi / Farrero, Marta / Bodro, Marta

Vaccines

2023 Volume 11, Issue 12

Abstract: The aim of the present study was to determine humoral and T-cell responses after four doses of mRNA-1273 vaccine in solid organ transplant (SOT) recipients, and to study predictors of immunogenicity, including the role of previous SARS-CoV-2 infection in ...

Abstract	The aim of the present study was to determine humoral and T-cell responses after four doses of mRNA-1273 vaccine in solid organ transplant (SOT) recipients, and to study predictors of immunogenicity, including the role of previous SARS-CoV-2 infection in immunity. Secondarily, safety was also assessed. Liver, heart, and kidney transplant recipients eligible for SARS-CoV-2 vaccination from three different institutions in Barcelona, Spain were included. IgM/IgG antibodies and T cell ELISpot against the S protein four weeks after receiving four consecutive booster doses of the vaccine were analyzed. One hundred and forty-three SOT recipients were included (41% liver, 38% heart, and 21% kidney). The median time from transplantation to vaccination was 6.6 years (SD 7.4). In total, 93% of the patients developed SARS-CoV-2 IgM/IgG antibodies and 94% S-ELISpot positivity. In total, 97% of recipients developed either humoral or cellular response (100% of liver recipients, 95% of heart recipients, and 88% of kidney recipients). Hypogammaglobulinemia was associated with the absence of SARS-CoV-2 IgG/IgM antibodies and S-ELISpot reactivity after vaccination, whereas past symptomatic SARS-CoV-2 infection was associated with SARS-CoV-2 IgG/IgM antibodies and S-ELISpot reactivity. Local and systemic side effects were generally mild or moderate, and no recipients experienced the development of de novo DSA or graft dysfunction following vaccination.
Language	English
Publishing date	2023-12-13
Publishing country	Switzerland
Document type	Journal Article
ZDB-ID	2703319-3
ISSN	2076-393X
ISSN	2076-393X
DOI	10.3390/vaccines11121845
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Article ; Online: Improving the Access of Highly Sensitized Patients to Kidney Transplantation From Deceased Donors: The Spanish PATHI Program With Allocation Based on the Virtual Crossmatch.

Valentin, Maria O / Crespo, Marta / Fernandez, Constantino / Muro, Manuel / Vega, Rocio / Palou, Eduard / Ruiz, Juan Carlos / Diekman, Fritz / Padilla, Maria / Mancebo, Esther / Perez, Isabel / Andres, Amado / Ontañon, Jesus / Dominguez-Gil, Beatriz

Transplantation

2023 Volume 108, Issue 3, Page(s) 787–801

Abstract: Background: In 2015, the Spanish National Transplant Organization developed a prioritization system (Program for Access to Transplantation for Highly Sensitized Patients [PATHI]) to increase transplant options for patients with calculated panel-reactive ...

Abstract	Background: In 2015, the Spanish National Transplant Organization developed a prioritization system (Program for Access to Transplantation for Highly Sensitized Patients [PATHI]) to increase transplant options for patients with calculated panel-reactive antibodies (cPRAs) ≥98%, based on virtual crossmatch. We describe the experience with the implementation of PATHI and assess its efficacy. Methods: PATHI registry was used to collect characteristics of donors and patients between June 15, 2015, and March 1, 2018. One-year graft and patient survival and acute rejection were also measured. A Cox model was used to identify factors related to patient death and graft loss and logistical regression for those associated with rejection. Results: One thousand eighty-nine patients were included, and 272 (25%) were transplanted. Transplant rate by cPRA was 54.9%, 40.5%, and 12.8% in patients with cPRA98%, cPRA99%, and cPRA100%, respectively. One-year patient survival was 92.5%. Recipient age ≥60, time under dialysis >7 y, and delayed graft function were mortality risk factors. One-year graft survival was 88.7%. The factor related to graft loss was delayed graft function. The rejection rate was 22%. Factors related to rejection were sex, older recipients, and posttransplant donor-specific antibodies. Conclusions: A prioritization approach increases transplant options for highly sensitized patients with appropriate short-term postransplant outcomes. Along with other programs, PATHI may inspire other countries to adopt strategies to meet transplant needs of these patients.
MeSH term(s)	Humans ; Kidney Transplantation/adverse effects ; Delayed Graft Function/etiology ; Graft Rejection/prevention & control ; Tissue Donors ; Graft Survival ; Antibodies ; Histocompatibility Testing ; HLA Antigens
Chemical Substances	Antibodies ; HLA Antigens
Language	English
Publishing date	2023-10-23
Publishing country	United States
Document type	Journal Article
ZDB-ID	208424-7
ISSN	1534-6080 ; 0041-1337
ISSN (online)	1534-6080
ISSN	0041-1337
DOI	10.1097/TP.0000000000004824
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Zs.A 488: Show issues			Location: Je nach Verfügbarkeit (siehe Angabe bei Bestand) bis Jg. 1994: Bestellungen von Artikeln über das Online-Bestellformular Jg. 1995 - 2021: Lesesall (1.OG) ab Jg. 2022: Lesesaal (EG)
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Article ; Online: Extracorporeal Photopheresis Improves Graft Survival in a Full-Mismatch Rat Model of Kidney Transplantation.

Piñeiro, Gaston J / Lazo-Rodriguez, Marta / Ventura-Aguiar, Pedro / Ramirez-Bajo, Maria J / Banon-Maneus, Elisenda / Lozano, Miquel / Cid, Joan / Hierro-Garcia, Natalia / Cucchiari, David / Revuelta, Ignacio / Montagud-Marrahi, Enrique / Palou, Eduard / Bayés-Genís, Beatriu / Campistol, Josep M / Diekmann, Fritz / Rovira, Jordi

Transplant international : official journal of the European Society for Organ Transplantation

2023 Volume 36, Page(s) 10840

Abstract: Extracorporeal photopheresis (ECP) is an immunomodulatory therapy based on the infusion of autologous cellular products exposed to ultraviolet light (UV) in the presence of a photosensitizer. The study evaluates the ECP efficacy as induction therapy in a ...

Abstract	Extracorporeal photopheresis (ECP) is an immunomodulatory therapy based on the infusion of autologous cellular products exposed to ultraviolet light (UV) in the presence of a photosensitizer. The study evaluates the ECP efficacy as induction therapy in a full-mismatch kidney transplant rat model. Dark Agouti to Lewis (DA-L) kidney transplant model has been established. ECP product was obtained from Lewis rat recipients after DA kidney graft transplantation (Lew
MeSH term(s)	Rats ; Animals ; Kidney Transplantation ; Photopheresis ; Graft Survival ; Rats, Inbred Lew ; Graft Rejection/prevention & control ; Antibodies
Chemical Substances	Antibodies
Language	English
Publishing date	2023-01-12
Publishing country	Switzerland
Document type	Journal Article
ZDB-ID	639435-8
ISSN	1432-2277 ; 0934-0874
ISSN (online)	1432-2277
ISSN	0934-0874
DOI	10.3389/ti.2023.10840
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Zs.A 2358: Show issues

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Article ; Online: Overcoming limits: First ABO incompatible living donor paired kidney transplant in an hypersensitized pediatric recipient in Spain.

Calzada, Yolanda / Revuelta, Ignacio / Codina, Elena / Alcaraz, Antonio / López-Báez, Víctor / Paredes, David / Arango, Pedro / Palou, Eduard / Garcia-Herrera, Adriana / Oppenheimer, Federico / Diekmann, Fritz / Madrid, Álvaro

Pediatric transplantation

2022 Volume 26, Issue 8, Page(s) e14359

Abstract: Introduction: HLA sensitization is a growing problem in children awaiting kidney transplantation. In some cases, finding an immunologically compatible donor entails contemplating the option of an ABO incompatible transplant or paired transplant.: ... ...

Abstract	Introduction: HLA sensitization is a growing problem in children awaiting kidney transplantation. In some cases, finding an immunologically compatible donor entails contemplating the option of an ABO incompatible transplant or paired transplant. Methods: Patient with genetic nephrotic syndrome and progressive chronic kidney disease, with a previous thrombosis of a first kidney transplant, resulting hypersensitized and remaining for a long-time on hemodialysis. Despite a desensitization strategy, family members were incompatible and deceased donation options must be ruled out due to the presentation of donor-specific antibodies (DSA). After 4 years, the possibility arises to perform a kidney paired transplant with a 62-year-old woman with an incompatible blood group. Although the current cytotoxicity- and cell-based crossmatches were negative, history of DSA were recorded. Results: An intensive ABO and HLA desensitization protocol was performed in order to combat the isohemagglutinin antibodies and on the memory-HLA, based on rituximab, apheresis sessions, and immunoglobulins. Despite the donor being older in terms of pediatric transplantation, the donor-recipient weight difference, and immunological risk, the transplant was completed successfully. Maintenance of titration of up to 1/2 was confirmed after 3 weeks post-transplant (IgM and IgG). Kidney biopsy at 2 weeks and 6 months without signs of rejection. The patient is currently 12 months post-transplant and has not presented any signs of transplant rejection and has proper renal function. Conclusions: Kidney paired transplantation is an excellent solution for hypersensitized children, and ABO incompatibility can be considered to increase their options to find a good donor, without thereby obtaining worse results.
MeSH term(s)	Humans ; Child ; Female ; Middle Aged ; Living Donors ; Kidney Transplantation/methods ; Blood Group Incompatibility ; ABO Blood-Group System ; Spain ; Graft Rejection
Chemical Substances	ABO Blood-Group System
Language	English
Publishing date	2022-07-17
Publishing country	Denmark
Document type	Case Reports
ZDB-ID	1390284-2
ISSN	1399-3046 ; 1397-3142
ISSN (online)	1399-3046
ISSN	1397-3142
DOI	10.1111/petr.14359
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Zs.A 4947: Show issues

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Article ; Online: On the clinical relevance of using complete high-resolution HLA typing for an accurate interpretation of posttransplant immune-mediated graft outcomes.

Frontiers in immunology

2022 Volume 13, Page(s) 924825

Abstract: Complete and high-resolution (HR) HLA typing improves the accurate assessment of donor-recipient compatibility and pre-transplant donor-specific antibodies (DSA). However, the value of this information to ... ...

Abstract	Complete and high-resolution (HR) HLA typing improves the accurate assessment of donor-recipient compatibility and pre-transplant donor-specific antibodies (DSA). However, the value of this information to identify
MeSH term(s)	Graft Rejection/diagnosis ; Graft Survival ; HLA Antigens/genetics ; HLA-C Antigens ; Histocompatibility Testing ; Humans
Chemical Substances	HLA Antigens ; HLA-C Antigens
Language	English
Publishing date	2022-09-29
Publishing country	Switzerland
Document type	Journal Article ; Research Support, Non-U.S. Gov't
ZDB-ID	2606827-8
ISSN	1664-3224 ; 1664-3224
ISSN (online)	1664-3224
ISSN	1664-3224
DOI	10.3389/fimmu.2022.924825
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Article ; Online: Chimeric HLA antibody receptor T cells for targeted therapy of antibody-mediated rejection in transplantation.

Betriu, Sergi / Rovira, Jordi / Arana, Carolt / García-Busquets, Ainhoa / Matilla-Martinez, Marina / Ramirez-Bajo, Maria J / Bañon-Maneus, Elisenda / Lazo-Rodriguez, Marta / Bartoló-Ibars, Ariadna / Claas, Frans H J / Mulder, Arend / Heidt, Sebastiaan / Juan, Manel / Bayés-Genís, Beatriu / Campistol, Josep M / Palou, Eduard / Diekmann, Fritz

HLA

2023 Volume 102, Issue 4, Page(s) 449–463

Abstract: The presence of donor-specific antibodies (DSA), mainly against HLA, increases the risk of allograft rejection. Moreover, antibody-mediated rejection (ABMR) remains an important barrier to optimal long-term outcomes after solid organ transplantation. The ...

Abstract	The presence of donor-specific antibodies (DSA), mainly against HLA, increases the risk of allograft rejection. Moreover, antibody-mediated rejection (ABMR) remains an important barrier to optimal long-term outcomes after solid organ transplantation. The development of chimeric autoantibody receptor T lymphocytes has been postulated for targeted therapy of autoimmune diseases. We aimed to develop a targeted therapy for DSA desensitization and ABMR, generating T cells with a chimeric HLA antibody receptor (CHAR) that specifically eliminates DSA-producing B cells. We have genetically engineered an HLA-A2-specific CHAR (A2-CHAR) and transduced it into human T cells. Then, we have performed in vitro experiments such as cytokine measurement, effector cell activation, and cytotoxicity against anti-HLA-A2 antibody-expressing target cells. In addition, we have performed A2-CHAR-Tc cytotoxic assays in an immunodeficient mouse model. A2-CHAR expressing T cells could selectively eliminate HLA-A2 antibody-producing B cells in vitro. The cytotoxic capacity of A2-CHAR expressing T cells mainly depended on Granzyme B release. In the NSG mouse model, A2-CHAR-T cells could identify and eradicate HLA-A2 antibody-producing B cells even when those cells are localized in the bone marrow. This ability is effector:target ratio dependent. CHAR technology generates potent and functional human cytotoxic T cells to target alloreactive HLA class I antibody-producing B cells. Thus, we consider that CHAR technology may be used as a selective desensitization protocol or an ABMR therapy in transplantation.
MeSH term(s)	Mice ; Animals ; Humans ; HLA Antigens/genetics ; Graft Rejection ; Alleles ; Antibodies ; HLA-A2 Antigen/genetics ; Receptors, Antigen, T-Cell ; Isoantibodies
Chemical Substances	HLA Antigens ; Antibodies ; HLA-A2 Antigen ; Receptors, Antigen, T-Cell ; Isoantibodies
Language	English
Publishing date	2023-07-28
Publishing country	England
Document type	Journal Article ; Research Support, Non-U.S. Gov't
ZDB-ID	2845111-9
ISSN	2059-2310 ; 2059-2302
ISSN (online)	2059-2310
ISSN	2059-2302
DOI	10.1111/tan.15156
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Zs.A 661: Show issues

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Article ; Online: Kidney Graft Outcomes in High Immunological Risk Simultaneous Liver-Kidney Transplants.

Piñeiro, Gastón J / Rovira, Jordi / Montagud-Marrahí, Enrique / Torregrosa, Jose V / Ríos, José / Cucchiari, David / Ugalde-Altamirano, Jessica / Ventura-Aguiar, Pedro / Gelpi, Rosana / Palou, Eduard / Colmenero, Jordi / Navasa, Miquel / Diekmann, Fritz / Esforzado, Nuria

Liver transplantation : official publication of the American Association for the Study of Liver Diseases and the International Liver Transplantation Society

2020 Volume 26, Issue 4, Page(s) 517–527

Abstract: Recipients of simultaneous liver-kidney transplantations (SLKTs) have a lower risk of rejection compared with recipients of kidney transplants alone. However, there is disagreement about the impact of pretransplant anti-human leukocyte antigen ... ...

Abstract	Recipients of simultaneous liver-kidney transplantations (SLKTs) have a lower risk of rejection compared with recipients of kidney transplants alone. However, there is disagreement about the impact of pretransplant anti-human leukocyte antigen sensitization on patient and kidney graft survival in the long term. The aim of the study was to evaluate the impact of the recipient immunological risk and comorbidities in renal graft outcomes on SLKT. We reviewed the SLKTs performed in our center from May 1993 until September 2017. Patient and graft survival were analyzed according to the immunological risk, comorbidities, liver and kidney rejection episodes, immunosuppression, and infections. A total of 20 recipients of SLKT were considered in the high immunological risk (HIR) group, and 68 recipients were included in the low immunological risk (LIR) control group. The prevalence of hepatitis C virus infection, second renal transplant, and time on dialysis prior to transplantation were significantly higher in the HIR group. The incidence of acute kidney rejection was higher in the HIR group (P<0.01). However, death-censored kidney graft survival as well as the estimated glomerular filtration rate at follow-up were not different between the 2 groups. Comorbidities, but not the immunological risk, impact negatively on patient survival. Despite the higher incidence of rejection in the HIR SLKT group, longterm renal function and graft survival were similar to the LIR group.
MeSH term(s)	Graft Rejection/epidemiology ; Graft Survival ; Humans ; Kidney Transplantation/adverse effects ; Liver Transplantation/adverse effects ; Renal Dialysis ; Retrospective Studies ; Treatment Outcome
Language	English
Publishing date	2020-02-03
Publishing country	United States
Document type	Journal Article ; Research Support, Non-U.S. Gov't ; Review
ZDB-ID	2006866-9
ISSN	1527-6473 ; 1527-6465
ISSN (online)	1527-6473
ISSN	1527-6465
DOI	10.1002/lt.25726
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Zs.A 4702: Show issues

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Article ; Online: Increased risk of late-onset, immune-mediated, adverse reactions related to dermal fillers in patients bearing HLA-B08 and DRB103 haplotypes.

Decates, Tom S / Velthuis, Peter J / Schelke, Leonie W / Lardy, Neubury / Palou, Eduard / Schwartz, Simo / Bachour, Yara / Niessen, Frank B / Nijsten, Tamar / Alijotas-Reig, Jaume

Dermatologic therapy

2020 Volume 34, Issue 1, Page(s) e14644

Abstract: Even though manufacturers claim that the dermal fillers are nontoxic and nonimmunogenic, adverse events may occur. Clinically and histologically, most of the late onset adverse events present as an inflammatory response. To assess whether HLA ... ...

Abstract	Even though manufacturers claim that the dermal fillers are nontoxic and nonimmunogenic, adverse events may occur. Clinically and histologically, most of the late onset adverse events present as an inflammatory response. To assess whether HLA polymorphisms are associated with late-onset inflammatory adverse events related to dermal fillers. A total of 211 patients were included, of whom 129 experienced late-onset inflammatory adverse events to different fillers (Inflammation group) and 82 who did not (Reference group). Patients completed a standardized questionnaire and provided a blood sample or oral swap for HLA testing. The study population consisted of 188 (89%) women and 23 (11%) men. The two study groups were similar in the distributions of filler type, location of injecting, allergy, autoimmune disease, gender, age, ethnicity, and smoking status. Of the 211 patients in the sample, 25 had the combination of HLA subtype-B08 and HLA subtype-DRB103. This was 16.3% of the inflammatory group and 4.9% of the reference group. This combination of HLA subtypes was associated with an almost 4-fold increase in the odds of developing immune mediated adverse events (odds ratio = 3.79, 95% CI 1.25-11.48). Genetic polymorphisms such as HLA combinations may identify patients at risk of developing late onset immune mediated adverse events to dermal fillers.
MeSH term(s)	Autoimmune Diseases ; Case-Control Studies ; Dermal Fillers/adverse effects ; Female ; Genetic Predisposition to Disease ; HLA-B Antigens/genetics ; HLA-DRB1 Chains/genetics ; Haplotypes ; Humans ; Hypersensitivity ; Inflammation ; Male
Chemical Substances	Dermal Fillers ; HLA-B Antigens ; HLA-DRB1 Chains
Language	English
Publishing date	2020-12-19
Publishing country	United States
Document type	Journal Article ; Research Support, Non-U.S. Gov't
ZDB-ID	1354801-3
ISSN	1529-8019 ; 1396-0296
ISSN (online)	1529-8019
ISSN	1396-0296
DOI	10.1111/dth.14644
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Zs.A 5181: Show issues

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Article ; Online: Donor/Recipient HLA Molecular Mismatch Scores Predict Primary Humoral and Cellular Alloimmunity in Kidney Transplantation.

Meneghini, Maria / Crespo, Elena / Niemann, Matthias / Torija, Alba / Lloberas, Nuria / Pernin, Vincent / Fontova, Pere / Melilli, Edoardo / Favà, Alexandre / Montero, Nuria / Manonelles, Anna / Cruzado, Josep Maria / Palou, Eduard / Martorell, Jaume / Grinyó, Josep Maria / Bestard, Oriol

Frontiers in immunology

2021 Volume 11, Page(s) 623276

Abstract: Donor/recipient molecular human leukocyte antigen (HLA) mismatch predicts primary B-cell alloimmune activation, yet the impact ... ...

Abstract	Donor/recipient molecular human leukocyte antigen (HLA) mismatch predicts primary B-cell alloimmune activation, yet the impact on
MeSH term(s)	Adult ; Aged ; B-Lymphocytes/immunology ; B-Lymphocytes/pathology ; CD4-Positive T-Lymphocytes/immunology ; CD4-Positive T-Lymphocytes/pathology ; CD8-Positive T-Lymphocytes/metabolism ; CD8-Positive T-Lymphocytes/pathology ; Female ; Follow-Up Studies ; Graft Rejection/immunology ; Graft Rejection/pathology ; Graft Survival/immunology ; HLA-DQ Antigens/immunology ; Histocompatibility Testing ; Humans ; Immunity, Cellular ; Immunity, Humoral ; Kidney Transplantation ; Male ; Middle Aged
Chemical Substances	HLA-DQ Antigens
Language	English
Publishing date	2021-03-10
Publishing country	Switzerland
Document type	Clinical Trial ; Journal Article ; Multicenter Study ; Research Support, Non-U.S. Gov't
ZDB-ID	2606827-8
ISSN	1664-3224 ; 1664-3224
ISSN (online)	1664-3224
ISSN	1664-3224
DOI	10.3389/fimmu.2020.623276
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