Pretransplant anti-MICA antibodies and Impact on Renal Allograft Outcome

Blessymol Varghese, (2019) Pretransplant anti-MICA antibodies and Impact on Renal Allograft Outcome. Masters thesis, Christian Medical College, Vellore.


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OBJECTIVES: 1. To study the prevalence of anti-MICA antibodies in the Indian patient population awaiting renal transplantation. 2. To study the impact of anti-MICA antibodies in pre-transplantation sera on renal allograft outcome in recipients who have no donor specific anti HLA antibodies. MATERIALS AND METHODS: This was a retrospective unmatched case control study including CKD patients transplanted between January 2014 through December 2017 at CMC Vellore .There were 44 controls and 44 cases included in this study. Controls were CDC crossmatch negative and Luminex DSA (XmDSA) negative renal transplant recipients who had good graft outcome. Cases were CDC cross match negative and Luminex DSA(XmDSA) negative transplant recipients who had poor graft outcome characterised by either Acute Cellular Rejection, Antibody mediated rejection, acute graft dysfunction, slow graft function or any combination of the above mentioned outcomes. Prevalence of anti-MICA antibody was assessed in patients’ pre-transplantation sera using LABScreen mixed assay from one lambda. RESULTS: Out of a total of 88 patients 63 were Indians. The prevalence of anti-MICA antibody positivity in the overall group was 64.80 % and amongst the Indian patients was 65.1%. Pre-transplant anti-MICA antibody positivity was present in 75% of cases as opposed to 54.5% of controls (p= 0.038) indicating an association with poor graft outcome. No correlation was observed between anti-MICA antibody positivity and history of transfusion (p = 0.706) or pregnancy (p = 0.381). CONCLUSION: The prevalence of anti-MICA antibody positivity in pre transplant sera of Indian patients awaiting renal transplantation was higher in our study than that reported in literature. Positivity of anti-MICA antibody in pre transplantation sera is associated with poor renal allograft outcome. This finding assumes significance particularly in patients negative for anti- HLA antibodies who have poor renal allograft outcomes.

Item Type: Thesis (Masters)
Uncontrolled Keywords: Anti-MICA antibodies, renal allograft rejection, Luminex DSA.
Subjects: MEDICAL > Immunohaematology Blood Transfusion
Depositing User: Subramani R
Date Deposited: 19 Aug 2019 00:59
Last Modified: 19 Aug 2019 00:59

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