In terminally ill patients, organ transplantation could be recommended as the treatment of choice. In Korea, living donor liver or kidney transplantation is much more frequent than deceased donor transplantation due to organ shortages from deceased donors. ABO or HLA incompatibility in transplantation can be a major barrier in living donor transplantation. Currently, the rate of ABO incompatible organ transplantation accompanied by desensitization is 20~25% of living donor transplantation, and the blood bank laboratory plays an active role by plasmapheresis. The desensitization of HLA incompatible transplantation in highly sensitized patients is more difficult than that of ABO incompatible transplantation. The HLA antibody is not easy to remove and it is difficult to prevent sensitization. In addition, setting the target treatment goals and predicting the treatment outcomes based on the HLA antibody results are problematic. Therefore, a range of desensitization protocols have been attempted and various therapeutic goals have been introduced. This article reviews the various desensitization methods for antibody removal focusing on HLA incompatible kidney transplantation, and discusses the prognosis of desensitization methods for antibody removal based on the literature.
Blood Banks ; Humans ; Kidney Transplantation ; Korea ; Liver ; Living Donors ; Organ Transplantation ; Plasmapheresis ; Prognosis ; Terminally Ill ; Tissue Donors ; Transplantation ; Transplants

BACKGROUND: Epstein-Barr Virus (EBV) is one of the most prevalent causes of viral infection in humans. EBV infection stage (acute, past, or absent infection) is typically determined using a combination of assays that detect EBV-specific markers, such as IgG and IgM antibodies against the EBV viral capsid antigen (VCA) and IgG antibodies against the EBV nuclear antigen (EBNA). We compared the diagnostic performance and agreement of results between three commercial EBV antibody assays using an EBV performance panel (SeraCare Life Science, Milford, MA, USA) as a reference. METHODS: EBV antibody tests of EBV VCA IgM, VCA IgG, and EBNA IgG antibodies were performed by the Architect (Abbott Diagnostics, Wiesbaden, Germany), Liaison (DiaSorin, Saluggia, Italy), and Platelia (Bio-Rad, Marnes-la-Coquette, France) assays. Agreement between the three assays was evaluated using 279 clinical samples, and EBV DNA and antibody test results were compared. RESULTS: The three EBV antibody assays showed good diagnostic performance with good and excellent agreement with the performance panel (kappa coefficient, >0.6). The overall VCA IgM positivity rate was higher in EBV DNA-positive samples than in EBV DNA-negative samples for all three EBV antibody assays (P=0.02). The three EBV antibody assays exhibited good agreement in results for the clinical samples. CONCLUSIONS: The diagnostic performance of the three EBV antibody assays was acceptable, and they showed comparable agreement in results for the clinical samples.
Antibodies ; Biological Science Disciplines ; Capsid ; DNA ; Epstein-Barr Virus Infections ; Herpesvirus 4, Human* ; Humans ; Immunoglobulin G ; Immunoglobulin M ; Immunoglobulins

No abstract available.
B-Lymphocytes* ; Bone Marrow* ; Humans ; Lymphoma, B-Cell* ; Lymphoma, T-Cell* ; T-Lymphocytes*

No abstract available.
Antibodies* ; Kidney Transplantation* ; Kidney*

No abstract available.
Hematopoietic Stem Cell Transplantation* ; Humans

BACKGROUND: The purpose of this study was to assess the quality of long-term-stored leftover blood samples, and to evaluate the long-term stability of selected serum biomarkers such as proteins, enzymes, electrolytes, and tumour markers. METHODS: Stored blood samples were transferred to our biobank after being used to conduct tests for routine medical examinations in one health care institution, and were preserved at or below -70degrees C for 4 years. We analysed 24 biomarkers whose levels had been reported 4 years ago and tested them using the same analyser, reagents, and methods by utilizing an ADVIA Centaur Immunoassay System (Siemens Healthcare Diagnostics, USA) or an ADVIA 2400 Chemistry System (Siemens, USA). RESULTS: A total of 15 out of the 24 tested biomarkers showed significant differences in paired Student t-tests (P<0.01). Among them, 5 biomarkers (free T3, free T4, thyroid stimulating hormone, carcino-embryonic antigen, and alpha feto-protein) showed significant differences and high correlation coefficients (R2>0.975). Two biomarkers, creatinine and rheumatoid arthritis factor, showed no significant differences but were poorly correlated with previously analysed data. Aspartate aminotransferase, alanine aminotransferase, hepatitis B virus (HBV) surface antigen, and insulin levels were discordant according to their reference ranges. A total of 3 biomarkers, C-reactive protein, cancer antigen 125, and HBV surface antibody, showed no significant differences and good correlations without discordant data. CONCLUSIONS: Our findings showed that long-term storage for more than 4 years can result in a considerable bias for variable biomarkers. Only 3 of the 24 biomarkers evaluated were found to be stable biomarkers. Long-term storage of leftover samples is not recommended for most chemical analyses.
Alanine Transaminase ; Antigens, Surface ; Arthritis, Rheumatoid ; Aspartate Aminotransferases ; Bias (Epidemiology) ; Biomarkers* ; C-Reactive Protein ; Chemistry ; Creatinine ; Delivery of Health Care ; Electrolytes ; Enzyme Stability ; Hepatitis B virus ; Humans ; Immunoassay ; Indicators and Reagents ; Insulin ; Methods ; Protein Stability ; Reference Values ; Serum ; Thyrotropin

AML relapsing as ALL has rarely been reported. We describe the case of a 62-yr-old man who was diagnosed with erythroleukemia with a complex karyotype and achieved complete hematologic and cytogenetic remission after induction chemotherapy. However, 4 months after the initial diagnosis, he showed relapse with blasts showing a different morphology and immunophenotype and was diagnosed with precursor B-cell ALL. The relapsing precursor B-cell ALL presented with the same leukemic clones as the primary erythroleukemia. Cytogenetic analysis of his bone marrow (BM) at the time of the primary erythroleukemia showed complex karyotypic abnormalities, including monosomy 5 and monosomy 7. At relapse, his BM showed reemergence of these leukemic clones of complex karyotypic abnormalities with clonal switch. To our knowledge, this is the first case of a lineage switch from erythroleukemia to ALL.
Acute Disease ; Antimetabolites, Antineoplastic/therapeutic use ; Bone Marrow Cells/pathology ; Cell Lineage ; Cell Transformation, Neoplastic ; Chromosome Deletion ; Chromosomes, Human, Pair 5 ; Chromosomes, Human, Pair 7 ; Cytarabine/therapeutic use ; Drug Therapy, Combination ; Humans ; Immunophenotyping ; Karyotyping ; Leukemia, Erythroblastic, Acute/*diagnosis/drug therapy ; Male ; Middle Aged ; Monosomy ; Naphthacenes/therapeutic use ; Precursor B-Cell Lymphoblastic Leukemia-Lymphoma/*diagnosis/pathology ; Recurrence

Hemochromatosis is a disorder of the iron metabolism leading to organ damage, such as skin pigmentation, liver cirrhosis, heart failure and diabetes, due to progressive tissue iron overload. Phlebotomy is currently the standard therapy for hemochromatosis, which prevents the progression of tissue damage. We report a case of hemochromatosis treated successfully by 'double red blood cell' phlebotomy using ALYX (Fenwal, DeerWeld, USA). A 60-year-old man presented with skin pigmentation around the armpit and an increase in the AST and ALT levels. Upon admission, the ferritin (1,443 ng/mL), AST (199 IU/L) and ALT (452 IU/L) were elevated. A liver biopsy revealed iron deposition in Kupffer cells and portal tracts. Four sessions of double red blood cell phlebotomies were performed for 3 months. The ferritin, AST and ALT levels decreased to 33 ng/mL, 105 IU/L and 188 IU/L, respectively. The patient had no adverse effects during treatment. This is the first report of the successful treatment of hemochromatosis by 'double red blood cell' phlebotomy in Korea.
Biopsy ; Erythrocytes ; Ferritins ; Heart Failure ; Hemochromatosis ; Humans ; Iron ; Iron Overload ; Korea ; Kupffer Cells ; Liver ; Liver Cirrhosis ; Middle Aged ; Phlebotomy ; Skin Pigmentation