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Summary
A patient awaiting a kidney transplant had strong lymphocyte crossmatch incompatibility due to anti-Lewis a (Lea) antibodies. These antibodies caused significant lymphocyte destruction, but Lewis substance effectively inhibited their activity.
Area of Science:
- Immunology
- Transplantation Science
- Serology
Background:
- Lymphocyte crossmatch is crucial for successful organ transplantation.
- Lewis blood group antigens (Lea, Leb) can be targets of clinically significant antibodies.
- Anti-Lea antibodies have been implicated in transplant complications.
Purpose of the Study:
- To report a case of strong lymphocyte crossmatch incompatibility caused by anti-Lea antibodies.
- To investigate the characteristics and inhibition of anti-Lea antibody activity.
Main Methods:
- Serological testing including lymphocyte crossmatch.
- Flow cytometry to assess antigenicity on B and T lymphocytes.
- Inhibition studies using Lewis substance.
Main Results:
- The renal transplant recipient was Le(a-b-) with potent anti-Lea and anti-LebH antibodies.
- The serum demonstrated significant cytotoxicity (>80%) against Le(a+) and Le(b+) lymphocytes.
- Lewis substance specifically inhibited the anti-Lea antibody activity without affecting HLA antibodies.
Conclusions:
- Anti-Lea antibodies can cause significant lymphocyte crossmatch incompatibility.
- Lewis antigen expression varies between B and T lymphocytes.
- Lewis substance is a specific inhibitor of anti-Lea antibody activity, offering potential therapeutic insights.