Acute Rejection Mediated by Preformed Anti-HLA-C Antibody in a Kidney Transplant Patient: A Case Report.
Joice Holanda Dias, Diogo Buarque Cordeiro Cabral, Alexandre de Holanda Cavalcanti Pinto et al.
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Case in brief
A 66-year-old male with a history of kidney transplantation returned to hemodialysis before receiving a second kidney transplant from a deceased donor. He presented with delayed graft function and was found to have acute antibody-mediated rejection associated with preformed anti-HLA-C antibodies. Treatment involved high-dose steroids, plasmapheresis, and immunoglobulin, leading to a successful response and stable graft function for three years.
What made this case unusual
The case highlights the role of preformed anti-HLA-C antibodies in acute rejection, which is less commonly recognized in kidney transplantation.
Diagnostic / clinical pearl
Clinicians should consider the potential impact of preformed anti-HLA-C antibodies on kidney transplant outcomes, as they can mediate acute rejection despite a negative crossmatch.
Why it matters
This case underscores the need for routine evaluation of anti-HLA-C antibodies in transplant recipients to better assess rejection risk and improve graft survival.