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MHC Class I related chain A (MICA) Antibodies - A potential cause of renal allograft rejection


1 Department of Transplant Immunology and Immunogenetics, All India Institute of Medical Sciences; Department of Pathology, Command Hospital, Pune, Maharashtra, India
2 Department of Nephrology, All India Institute of Medical Sciences, New Delhi, India
3 Department of Transplant Immunology and Immunogenetics, All India Institute of Medical Sciences, Pune, Maharashtra; National Chair, ICMR, New Delhi, India

Correspondence Address:
Narinder Mehra,
National Chair and Former Dean, All India Institute of Medical Sciences, Ansari Nagar, New Delhi - 110 029
India
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Source of Support: None, Conflict of Interest: None

DOI: 10.4103/ijn.IJN_407_20

MHC class I related chain A (MICA) antibodies, especially those directed against the donor in absence of donor-specific anti-HLA antibodies have been reported to be possibly associated with renal allograft rejection in sensitized recipients. We are the first ones to present a case series of five patients who underwent primary live related donor renal transplantation in non-sensitized recipients either in the presence of donor-specific MICA antibodies (MICA-DSA) or developed de novo. Four of them presented characteristics of either accelerated, acute or chronic antibody-mediated rejection (AMR) attributable to the presence of MICA DSA. This case series emphasizes that AMR due to MICA-DSA is amenable to treatment with conventional regimens for treatment of AMR and there is a need for screening of MICA antibodies especially those directed against the donor on case to case basis.


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    -  Agarwal SK
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Indian Journal of Nephrology
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Online since 20th Sept '07