Positive flow cytometry crossmatch with discrepant antibody testing results following COVID-19 vaccination.
Am J Transplant
; 21(11): 3785-3789, 2021 11.
Artículo
en Inglés
| MEDLINE | ID: covidwho-1304071
ABSTRACT
The impact of COVID-19 vaccination on the alloimmunity of transplant candidates is unknown. We report a case of positive B cell flow cytometry crossmatch in a patient waiting for second kidney transplantation, 37 days after receiving the COVID-19 vaccine. The preliminary crossmatch, using sample collected before COVID-19 vaccination, was negative. The antibodies to mismatched donor HLA-DR7 were detected only with multi-antigen beads but not with single-antigen beads, excluding possible prozone effects in solid-phase antibody assays. The crossmatches were positive with HLA-DR7-positive surrogates (n = 2) while negative with HLA-DR7-negative surrogates (n = 3), which confirms the HLA-DR7 alloreactivity. The antigen configurations on B lymphocytes are similar to that on the multi-antigen beads while distinct from the single-antigen beads. HLA-DR7 was the repeating mismatched antigen with the failing first kidney allograft. The newly emerged antibody to HLA-DR7 probably is the consequence of bystander activation of memory response by the COVID-19 vaccination. This case highlights the importance of verifying allo-sensitization history and utilizing multiple assays, including cell-based crossmatch and solid-phase assays with multi-antigens. COVID-19 immunization may deserve special attention when assessing the immunological risk before and after organ transplantation.
Palabras clave
Texto completo:
Disponible
Colección:
Bases de datos internacionales
Base de datos:
MEDLINE
Asunto principal:
Vacunas contra la COVID-19
/
COVID-19
Tipo de estudio:
Reporte de caso
/
Estudio experimental
/
Estudio pronóstico
Tópicos:
Vacunas
Límite:
Humanos
Idioma:
Inglés
Revista:
Am J Transplant
Asunto de la revista:
Trasplante
Año:
2021
Tipo del documento:
Artículo
País de afiliación:
Ajt.16753
Similares
MEDLINE
...
LILACS
LIS