Antibody-mediated rejection due to anti-HLA-DQ antibody after pregnancy and delivery in a female kidney transplant recipient.
Herein, we report a case of antibody-mediated rejection (ABMR) due to anti-HLA-DQ antibody after pregnancy and delivery in a female kidney transplant recipient. A 34-year-old female recipient was admitted at 2 years after delivery for an examination of an elevated serum creatinine (S-Cr) level. The patient had received a living kidney transplantation from her mother at 22 years of age, and her kidney graft function was almost stable. The episode biopsy showed peritubular capillaritis and transplant capillaropathy with C4d immunoreactivity in the peritubular capillaries. Additional examination revealed expression of a donor-specific antibody (DSA) against HLA-DQ5, leading to the diagnosis of chronic active ABMR. Intravenous immunoglobulin, plasma exchange, and rituximab were administered, and her S-Cr level was maintained stable. This case demonstrates a possible relationship between pregnancy/delivery and development of ABMR due to a de novo DSA in a female kidney transplant recipient.
['Sagasaki|Makoto|M|', 'Nakada|Yasuyuki|Y|', 'Yamamoto|Izumi|I|', 'Kawabe|Mayuko|M|', 'Yamakawa|Takafumi|T|', 'Katsumata|Haruki|H|', 'Mafune|Aki|A|', 'Katsuma|Ai|A|', 'Kobayashi|Akimitsu|A|', 'Koike|Kentaro|K|', 'Koike|Yusuke|Y|', 'Miki|Jun|J|', 'Yamada|Hiroki|H|', 'Kimura|Takahiro|T|', 'Tanno|Yudo|Y|', 'Ohkido|Ichiro|I|', 'Tsuboi|Nobuo|N|', 'Yamamoto|Hiroyasu|H|', 'Yokoo|Takashi|T|']
D000328:Adult D001706:Biopsy D015935:Complement C4b D005260:Female D006084:Graft Rejection D006085:Graft Survival D006683:HLA-DQ Antigens D006801:Humans D016756:Immunoglobulins, Intravenous D007150:Immunohistochemistry D007166:Immunosuppressive Agents D007518:Isoantibodies D007668:Kidney D016030:Kidney Transplantation D019520:Living Donors D036801:Parturition D010446:Peptide Fragments D010951:Plasma Exchange D011247:Pregnancy D000069283:Rituximab D013997:Time Factors D016896:Treatment Outcome
antibody-mediated rejection anti-HLA-DQ antibody pregnancy and delivery donor-specific antibody living related kidney transplantation