IgM antibodies in renal transplantation

A prospective final crossmatch with patient serum and donor lymphocytes using the complement‐dependent cytotoxicity assay to identify any preformed anti‐donor antibody is required for kidney transplantation. The presence of pre‐existing antibody may lead to hyperacute rejection of the transplanted kidney. Certain anti‐donor antibodies have previously been shown to be ineffective in promoting hyperacute rejection, such as IgM autoantibodies and non‐specific IgM lymphocytotoxic antibodies. In this report, we present evidence that IgM HLA alloantibody specific to the donor does not lead to hyperacute rejection and produces graft survival results equivalent to transplants with negative pre‐transplant final crossmatches. Forty‐eight (48) of 402 patients transplanted over an 8 yr period were transplanted across a positive final crossmatch due to IgM antibodies. alone. Three patients exhibited IgM autoantibodies and 26 patients demonstrated non‐specific IgM antibodies to lymphocytes. In 15 patients, following a detailed serum screening analysis, a significant correlation (r>0.9, p<0.001) was observed between HLA Class I antigens and the presence of corresponding IgM alloantibodies. Five of these patients were subsequently transplanted despite a positive final crossmatch that was clearly demonstrated to be the result of IgM alloantibody to donor HLA Class I specificities. All of these patients continue to have graft function. These results suggest that hyperacute rejection is not mediated by any type of IgM antibody to donor lymphocytes and that kidney transplantation when only IgM antibody is present against donor lymphocytes represents a reasonable opportunity for a safe transplant and successful long‐term graft survival.

• Publication year

  1997

• Venue

  Clinical Transplantation

• Publication date

  1997-12-01

• Fields of study

  Medicine

• Identifiers
  DOI 10.1111/j.1399-0012.1997.tb01042.xPMID 9408684
• External record

  Open on Semantic Scholar

• Source metadata

  Semantic Scholar, PubMed

• No claims are published for this paper.

• No concepts are published for this paper.

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