The ELISpot assay is a sensitive technique applied to assess cytokine-producing memory/effector T cells and human leukocyte antigens (HLA)-specific IgG-producing B cells. Besides the fact that the method is laborious and is difficult to standardise between laboratories, it may provide valuable information on the immune response of recipients before and after organ transplantation. In this article, we briefly review the recent literature and discuss the clinical significance of the ELISpot assay in predicting the risk and incidence of allograft rejection and survival.

• Klíčová slova
• ELISpot, HLA, antibodies, interferon-gamma, organ transplantation, rejection,
• MeSH
• ELISPOT MeSH
• interferon gama MeSH
• lidé MeSH
• rejekce štěpu * MeSH
• T-lymfocyty MeSH
• transplantace ledvin * MeSH
• Check Tag
• lidé MeSH
• Publikační typ
• časopisecké články MeSH
• přehledy MeSH
• Názvy látek
• interferon gama MeSH

Donor-specific antibodies (DSA) cause antibody-mediated rejection (AMR); however, their pathogenic role has not yet been adequately investigated after liver transplantation. The aim of our study was to analyse the clinical significance of DSA and complement-binding DSA for the prediction of AMR after liver transplantation. Our cohort included 120 liver recipients with assessed protocol biopsies one year post-transplant. All patients had defined HLA-specific and complement-binding (C1q + and C3d+) antibodies before and in regular intervals after transplantation. The incidence of DSA was evaluated in relation with clinical and histopathological data in the liver allografts. A higher occurrence of acute AMR was observed in recipients with preformed complement-binding DSA to HLA Class I antigens. Patients who developed chronic AMR had more frequently de novo-produced antibodies against HLA Class II antigens (P = 0.0002). A correlation was also found between de novo-formed C1q + and C3d+-binding antibodies to HLA Class II antigens and the development of chronic AMR (P = 0.043). Our study implies that preformed complement-binding DSA to HLA Class I antigens are related to increased risk of acute antibody-mediated rejection, while chronic AMR is more frequent in patients with de novo-produced antibodies to HLA Class II antigens after liver transplantation.

• Klíčová slova
• C4d deposits, HLA, complement-binding, donor-specific antibodies, rejection,
• MeSH
• dárci tkání MeSH
• HLA antigeny MeSH
• isoprotilátky MeSH
• komplement C1q MeSH
• lidé MeSH
• přežívání štěpu MeSH
• rejekce štěpu MeSH
• retrospektivní studie MeSH
• transplantace jater * škodlivé účinky   MeSH
• transplantace ledvin * MeSH
• Check Tag
• lidé MeSH
• Publikační typ
• časopisecké články MeSH
• práce podpořená grantem MeSH
• Názvy látek
• HLA antigeny MeSH
• isoprotilátky MeSH
• komplement C1q MeSH

The aim of our study was to evaluate the relevance of complement-binding donor-specific antibodies (DSA) for prediction of antibody-mediated rejection (AMR) after liver transplantation. Sera from 123 liver transplant recipients were retrospectively defined for HLA specificity and complement-fixing activity using the single antigen beads, C1q and C3d techniques. Liver-recipients' sera were tested before transplantation, 3, 6 months and 1 year after transplantation. Patients were followed up for graft survival and rejection incidence for 1 year after transplantation. All patients with pretransplant complement-binding DSA developed severe AMR after transplantation, while three recipients out of four, who produced de novo complement-fixing DSA, developed AMR. Definition of DSA with respect to complement-fixing activity may provide clinically relevant information about the risk of AMR after liver transplantation.

• Klíčová slova
• C4d, HLA, antibodies, complement, crossmatch, liver transplantation, rejection,
• MeSH
• dárci tkání MeSH
• dítě MeSH
• dospělí MeSH
• homologní transplantace MeSH
• isoprotilátky krev   MeSH
• komplement C1q metabolismus   MeSH
• komplement C3d metabolismus   MeSH
• lidé středního věku MeSH
• lidé MeSH
• mladiství MeSH
• následné studie MeSH
• přežívání štěpu * MeSH
• prognóza MeSH
• rejekce štěpu krev   diagnóza   imunologie   patologie   MeSH
• retrospektivní studie MeSH
• senioři MeSH
• testování histokompatibility metody   MeSH
• transplantace jater * MeSH
• Check Tag
• dítě MeSH
• dospělí MeSH
• lidé středního věku MeSH
• lidé MeSH
• mladiství MeSH
• mužské pohlaví MeSH
• senioři MeSH
• ženské pohlaví MeSH
• Publikační typ
• časopisecké články MeSH
• práce podpořená grantem MeSH
• Názvy látek
• isoprotilátky MeSH
• komplement C1q MeSH
• komplement C3d MeSH

A novel therapeutic approach to refractory acute antibody-mediated rejection (AMR) in kidney transplant recipients was applied in 23 patients based on administration of Bortezomib, intravenous corticosteroids, plasmapheresis and Rituximab. Application of Bortezomib regimen led to diminishing of donor-specific antibodies (DSA) to HLA-B (P = 0.004) and HLA-DR (P = 0.0005), but not to HLA-A (P = 0.106) and HLA-DQ antigens (P = 0.18). Patients with good clinical response to treatment had significantly better allograft survival than recipients with continuing deterioration of graft function (P = 0.019). Graft survival after therapy of refractory AMR was significantly worse than survival after first transplantation and was comparable with outcomes after retransplantation. In conclusion, therapy with Bortezomib was well tolerated and effective in decreasing the levels of HLA-B and -DR antibodies, however, was not successful in depleting HLA-A and -DQ DSA.

• Klíčová slova
• Bortezomib, antibody-mediated rejection, donor-specific antibodies, intravenous immunoglobulins, plasmapheresis,
• MeSH
• bezpečnost pacientů MeSH
• bortezomib terapeutické užití   MeSH
• dárci tkání MeSH
• dospělí MeSH
• HLA antigeny genetika   imunologie   MeSH
• homologní transplantace MeSH
• hormony kůry nadledvin terapeutické užití   MeSH
• imunologické faktory terapeutické užití   MeSH
• isoprotilátky krev   MeSH
• lidé středního věku MeSH
• lidé MeSH
• pilotní projekty MeSH
• plazmaferéza metody   MeSH
• přežívání štěpu * MeSH
• prognóza MeSH
• rejekce štěpu krev   diagnóza   imunologie   patologie   MeSH
• rituximab terapeutické užití   MeSH
• rozvrh dávkování léků MeSH
• testování histokompatibility metody   MeSH
• transplantace ledvin * MeSH
• výsledek terapie MeSH
• Check Tag
• dospělí MeSH
• lidé středního věku MeSH
• lidé MeSH
• mužské pohlaví MeSH
• ženské pohlaví MeSH
• Publikační typ
• časopisecké články MeSH
• práce podpořená grantem MeSH
• Názvy látek
• bortezomib MeSH
• HLA antigeny MeSH
• hormony kůry nadledvin MeSH
• imunologické faktory MeSH
• isoprotilátky MeSH
• rituximab MeSH