Transplantation.pdf (331.49 kB)
Spontaneous and therapeutic glycosidic accommodation of host and graft in ABO(H)-incompatible transplantation, a hypothesis.
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thesis
posted on 2016-06-29, 10:40 authored by Peter ArendPeter ArendIn
contrast to non-nucleated ABO(H) red cells, which when transfused to a blood
group O(H) recipient undergo destruction within minutes, such hyperacute, humoral
rejection occurs relatively rarely in transplantations of highly nucleated, metabolically
active solid organs; it is extremely rare in liver transplantations (Adams, 1991) (Della-Guardia et
al., 2008) and does not occur after successful bone marrow
engraftment (Takahashi, 2005). Moreover, a case of transient, selective disappearance of
pre-existing host-specific HLA-antibodies after an incompatible liver
transplantation, without any rejection episodes, has been reported by Bastiani
(2006), and according to Taner et al. (2014) such transient decrease of host-specific HLA-antibodies
is not uncommon after incompatible liver transplantation. Treatment of pure red cell aplasia (PRCA) with ABO incompatible RBC, after
ABO blood group incompatible hematopoietic stem cell
transplantation, was followed by spontaneous
fall of isoagglutinin levels in several individuals (Stussi et al. 2009). In addition, an exponential
fall in both anti-A/B reactive IgM and IgG titers was observed after ABO(H)
incompatible bone marrow transplantation (Rowley et al. 2000; Lee et al. 2003). These phenomena,
occurring in “major incompatibilities”, most likely reflect a complex mechanism,
in which pre-existing anti-graft-reactive immunoglobulins of the host are
adsorbed on complementary sites on the cell surfaces of the graft, but unlike on
red cell surfaces, they appear to be completed by graft-phenotype-specific protective
glycosylation, which suggests its targeted use in a hypothetical therapeutic
regimen.
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- Analytical biochemistry
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- Evolution of developmental systems
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