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Antibodies Increase Risk of Kidney Transplant Rejection

Increase observed even in well-matched patients

WEDNESDAY, Sept. 26 (HealthDay News) -- The presence of antibodies against a particular surface antigen increases the likelihood of kidney transplant rejection, even when the patient and kidney are well matched, researchers report in the Sept. 27 issue of the New England Journal of Medicine.

Peter Stastny, M.D., from the University of Texas Southwestern Medical Center in Dallas, and colleagues measured antibodies against major-histocompatibility-complex class I-related chain A (MICA) in preimplantation serum samples from 1,910 transplant recipients of kidneys from deceased organ donors.

The researchers found that 11.4 percent of patients had anti-MICA antibodies. The mean one-year graft survival rate was significantly higher in patients without antibodies (93.0 versus 88.3 percent). The difference in mean one-year graft survival was more pronounced in the 326 recipients who were well matched for human leukocyte antigen (95.1 versus 83.2 percent).

"Although human leukocyte antigen remains the cornerstone of transplantation immunology, the exploration of MICA antigens and their corresponding antibodies may be seen as a new tool set for understanding the rejection of kidney transplants," Willy A. Flegel, M.D., from University Hospital in Ulm, Germany, writes in an accompanying editorial.

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