Has anyone done an HLA Antibody Test after transplant?
Background: HLA antibody testing can also be performed after a transplant. This is because a recipient may develop antibodies against the donor's HLA antigens even after the transplant has taken place.
These antibodies are called donor-specific antibodies (DSA).
The presence of DSAs can increase the risk of an episode of antibody-mediated rejection (AMR), which can damage the transplanted organ.
Thanks in advance for your responses!
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SouthwoodTiger
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Usually it is ordered if there is suspicious lab result. They should be on top of your labs and clinical condition and order any labs that are necessary. Do you have a reason to worry about it?
It seemed to come with the package of acquiring a kidney through New England Donor Procurement Agency. Had it done twice since transplant 10 months ago. All is well.
I had it done every three months or so the first year or 18 months. Now they do it annually at my anniversary appointment. An RN friend says the annual monitoring is likely due to the myriad of issues I've had over the last five years, including a creatinine level not significantly improved from pre-transplant days for the first three years. Thankfully that seems to finally be coming down, but it's been a long journey. If your team thinks it's necessary, they'll order it. So far, my insurance has covered it completely, which is a godsend due to the cost of the test! Best wishes!
I was listed at UCLA. They do the donor specific antibody test at the end of the first year. Beyond that I don’t know what they do. Their wait list was 7 years for blood type B kidney, and 4 years for an ABO Incompatible donor.
I received my transplant at the Mayo Clinic in Phoenix, Az. They don’t bother with that test. They do a kidney biopsy at 4 months and 1 year. That’s the gold standard test for rejection.
I received a high risk transplant. I only matched 2 of the 7 antigens. But, I have never been pregnant, had a blood transfusion, or previous transplant. I had no antibodies to anyone else’s cells. Therefore I will never get T-cell rejection, but I could still get B-cell rejection.
However, I am blood type B. I received a blood type A (sub 2) kidney. Apparenly there are two types of blood type A (don’t ask me to explain, I can’t). This is called an ABO Incompatible match. Higher risk of rejection. I chose to do this because I didn’t want to spend years and years on dialysis I received a blood type A (sub2) kidney after only 11 months and 3 weeks on the transplant list.
I am one year and 5 days post transplant, biopsy this week, negative for rejection .
They have me on prednisone, the steroid from h***. I’ve gained 25 pounds. I’ve had significant bone loss. My A1C is now pre-diabetic which it was not before. They’ve agreed to cut my steroid dose by half. However, they plan to run that donor specific antibody test every 3 months for a year at least.
My hubby had the test done simply as a precaution when his albumin jumped. But, as the nephs suspected, it came back fine and wasn't due to rejection. (Apparently the reasons for it was a uti and possibly increased atrophy of native kidneys.) Similar to what Lisa Snow said, our center only performs this test when something in the lab data catches their attention. And a kidney biopsy on a transplant is only done when absolutely necessary. We accepted a transplant that wasn't a perfect match and came with conditions, but it has done really well so far - three years at the end of this month.
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