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Paper Information

Title: 

PROSPECTIVE STUDY OF MICHROCHIMERISM IN RENAL ALLOGRAFT RECIPIENTS : ASSOCIATION BETWEEN HLA DR MATCHING , MICROCHIMERISM AND ACUTE REJECTION

Type: PAPER
Author(s): POURMAND GHOLAMREZA,TAJIK NADER,SINGAL D.P.,EBRAHIMIRAD MOOHAMADREZA,RADJABZADEH M.F.,TAVASOLI P.,KHOSRAVI FARIDEH,NIKBIN BEHROZ
 
 
 
Name of Seminar: CONGREH ANJOMAN UROLOGY IRAN
Type of Seminar:  CONGRESS
Sponsor:  ANJOMAN OROLOGY
Date:  2005Volume 8
 
 
Abstract: 

INTRODUCTION AND OBJECTIVES: THE PRESENCE OF DONOR-DERIVED HEMATOPOIETIC CELLS IN BLOOD AND VARIOUS TISSUES OF THE ORJAN RECIPIENTS, TERMED ALLOGENEIC MICROCHIMERISM, HAS BEEN CONSIDERED TO PLAY AND ESSENTIAL ROLE IN ESTABLISHMENT OF ORGAN ACCEPTANCE. IN THIS STUDY, WE PROSPECTIVELY DETERMINED THE PRESENCE OF PERIPHERAL BLOOD MICROCHIMERISM (PBM) IN 20 MALE-TO-FEMALE RENAL ALLOGRAFT RECIPIENTS UP TO 30 MONTHS POST-TRANSPLANTATION.
METHODS: RECIPIENTS WERE CATEGORIZED ACCORDING TO THE PATTERN OF MICROCHIMERISM INTO MICROCHIMERIC AND NONMICROCHIMERIC GROUPS, AND THEN STATE OF HUMAN LEUKOCYTE ANTIGENS (HLA) CLASS II (DR/DQ) MATCHING, EPISODES OF ACUDE REJECTION, AGE AT TRANSPLANTATION, RENAL FUNCTION, AND HISTORY OF BLOOD TRANSFUSION WERE COMPARED. DNA WAS EXTRACTED FROM DONOR, PRE-TRANSPLANT, AND POST-TRANSPLANT (1 WK; 1, 3, 6, 12, 18, 24AND 30 MONTHS) PERIPHERAL BLOOD SAMPLES. WE ANALYZED PBM USING NESTED POLYMERASE CHAIN REACTION (PCR) AMPLIFICATION SPECIFIC FOR THE SRY REGION OF THE Y CHROMOSME WITH A SENSITIVITY UP TO 1: 1000000.
RESULTS: MICROCHIMERISM WAS DETECTED IN 13 (65%) OF 20 RECIPIENTS AT VARIOUS INTERVALS. THE HIGHEST FREQUENCY OF MICROCHIMERISM WAS AT 1 WK (55%). AMONG MICROCHIMERIC RECIPIENTS, NONE WERE POSITIVE ON ALL POST-TRANSPLANT ANALYSES.
INTERESTINGLY, NOMICROCHIMERIC CASES WERE NEGATIVE THOROUGHOUT THE STUDY. THE THREE RECIPIENTS WITH AN EPISODE OF ACUTE REJECTION DURING THE FIRST WEEK AFTER TRANSPLANTATION WERE ALL IN THE NONMICRICHIMERIC GROUP WITH COMPLETELY MISMATCHED HLA-DR ANTIGENS.
HLA-DR INCOMPATIBILITY WAS SIGNIFICANTLY LOWER (T-TEST, P<0.05) IN MICROCHIMERIC CASES (1.0+0.58) THAN IN NONMICRICHIMERIC ONES (1.9+0.38). BUT REGARDING HLA-DQ AND OTHER CLINICAL PARAMETERS MENTIONED ABOVE, SIGNIFICANT DIFFERENCE WAS NOT OBSERVED. WE PROPOSE THAT THERE IS AN ASSOCIATION BETWEEN HLA_DR MATCHING, MICROCHIMERISM AND ACUTE GRAFT REGECTIOM IN OUR RECRPIENTS.
CONCLUSIONC: OUR STUDY DEMONSTRATES THAT, WITH ROUTINE IMMUNOSUPPRESSIVE PROTOCOLS, HIGHER COMPATIBILITY OF HLA_DR ANTIGENS FACILITATES MICROCHIMERISM INDUCTION. THEN, DEVELOPMENT OF NEW STRONGER IMMUNOSUPPRESSIVE PROTOCOLS (INCLUDING CONDITIONING) OR AUGMENTATION OF CHIMERIC STATE (BY DONOR SPECIFIC BONE MARROW INFUSION), ESPECIALLY IN COMPLETELY MISMATCHED HLA_DR RENAL ALLOGRAFT RECIPIENTS, MAY BE USEFUL FOR GRAFT ACCEPTANCE.

 
Keyword(s): DONOR, RECIPIENT, MICROCHIMERISM, TRANSPLANTATION
 
 
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