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Background: Rejection is considered as a major barrier to achieve successful transplantation. Non self-human leucocyte antigen (HLA) is a well-known antigenic target for antibodies binding that can result in antibody-mediated rejection (AMR). To reduce risk of rejection in kidney transplant, preventive measures are undertaken, which include HLA-matching between donor and recipient, and in-vitro pre-transplant crossmatch with potential donor cells and recipient sera, furthermore, periodic HLA antibodies monitoring for donor-specific antibodies (DSA) is carried out before and after transplant. Nevertheless, allograft may still fail despite the above measures, which suggests other antigens besides HLA can also contribute to renal rejection. In fact, polymorphic major histocompatibility complex (MHC) class I–related chain A (MICA) antigens and Angiotensin II type 1 receptor (AT1R) antigens have been reported as likely targets in AMR. However, the effect of non-HLA antibodies such as anti-MICA and anti-AT1R antibodies in rejection are not fully defined. This implies there is an imminent need to elucidate the role of non-HLA antibodies in allograft AMR cases which are not mediated by HLA antibodies. Aim: To retrospectively evaluate the occurrence of MICA and AT1R antibodies in 21 clinical AMR cases without detectable HLA antibodies or HLA antibodies that were not target against donor HLA. Methods: Twenty-one cases with suspected non-HLA mediated post-transplant rejection were retrieved. Eplet analysis was utilized to confirm that the detectable HLA-DR antibodies in one of the samples were not cross-reactive towards a donor’s antigen. Sera from 21 non-AMR cases were used as controls. All sera were subjected to MICA antibody and AT1R antibody screening. Identified positive cases were further examined with their pre-transplant sera to assess whether the AT1R and/or MICA antibodies were already pre-formed before transplantation. The sensitization histories of transfusion, pregnancy and previous transplantation were recorded. Results: Nine of twenty-one cases were detected with MICA and/or AT1R antibodies. 7 samples were detected with MICA antibodies while 3 samples were detected with AT1R antibodies. A sample was detected with both MICA and AT1R antibodies. Importantly, the presence of MICA/AT1R antibodies appeared to be strongly associated with rejection caused by non-HLA antigens (p=0.0007). All controlled cases were found to be negative for MICA and AT1R antibodies. Pre-transplant sera of the positive cases were further screened and pre-formed antibodies were detected in 3 of the positive MICA cases, and 1 of the positive AT1R cases. Since no AT1R and MICA genotyping of the donor was carried out previously, it was uncertain that the allograft rejection was induced by the donor specific pre-formed antibodies generated in the pre-transplant sensitization events. Nonetheless, AT1R and MICA antibodies appeared to be induced by the allograft in the remaining 5 cases. Conclusion: Presence of MICA/AT1R antibodies appeared to be associated with the investigated AMR cases without detectable HLA antibodies. Some evidence suggested the production of these non-HLA antibodies could be induced by transfusion sensitization or allograft upon transplantation. / published_or_final_version / Pathology / Master / Master of Medical Sciences

Diss. (sammanfattning) Stockholm : Karol. inst., 2001. / Härtill 5 uppsatser.

Text in Afrikaans / In hierdie studie word die invloed van subtiele ouerlike verwerping op die leefwereld van die adolessent aangespreek. Subtiele ouerlike verwerping manifesteer nie net in die afwesigheid van liefde en warmte in die ouer-kind verhouding nie, maar vind ook neerslag in fisiese-, emosionele- en opvoedingsverwaarlosing. Uit die literatuurstudie blyk dit dat ouerlike houdings, wat in hul opvoedingstyl weerspieel word, bepalend is vir die adolessent se belewing van aanvaarding of verwerping. Oorsake van ouerlike verwerping setel in ouers se agtergrond, hul huidige omstandighede en die kind self. In die empiriese ondersoek is die leefwereld van die adolessent wat ouerlike verwerping beleef, verken. Volgens die resultate blyk dit dat hierdie adolessente se relasies problematies is, dat hulle 'n lae selfbeeld het en dat hulle gevoelens van angs en minderwaardigheid beleef. / This study addresses the influence of subtle parental rejection on the life world of adolescents. Subtle parental rejection manifests not only in the lack of warmth and love in the parent-child relationship but also in physical, emotional and educational neglect. From the literature study it is evident that, parental rejection which is reflected in their educational style will determine whether a child experiences rejection or acceptance. Causes of parental rejection reside in the background of parents, their existing circumstances and also in the rejected child itself. The empirical study investigates the life world of adolescents who experience subtle parental rejection. According to the results it seems that these adolescents experience problematic relationships, they have a low self-image and also experience feelings of anxiety and a sense of inferiority. / Psychology of Education / M. Ed. (Sielkundige Opvoedkunde)

Text in Afrikaans / In hierdie studie word die invloed van subtiele ouerlike verwerping op die leefwereld van die adolessent aangespreek. Subtiele ouerlike verwerping manifesteer nie net in die afwesigheid van liefde en warmte in die ouer-kind verhouding nie, maar vind ook neerslag in fisiese-, emosionele- en opvoedingsverwaarlosing. Uit die literatuurstudie blyk dit dat ouerlike houdings, wat in hul opvoedingstyl weerspieel word, bepalend is vir die adolessent se belewing van aanvaarding of verwerping. Oorsake van ouerlike verwerping setel in ouers se agtergrond, hul huidige omstandighede en die kind self. In die empiriese ondersoek is die leefwereld van die adolessent wat ouerlike verwerping beleef, verken. Volgens die resultate blyk dit dat hierdie adolessente se relasies problematies is, dat hulle 'n lae selfbeeld het en dat hulle gevoelens van angs en minderwaardigheid beleef. / This study addresses the influence of subtle parental rejection on the life world of adolescents. Subtle parental rejection manifests not only in the lack of warmth and love in the parent-child relationship but also in physical, emotional and educational neglect. From the literature study it is evident that, parental rejection which is reflected in their educational style will determine whether a child experiences rejection or acceptance. Causes of parental rejection reside in the background of parents, their existing circumstances and also in the rejected child itself. The empirical study investigates the life world of adolescents who experience subtle parental rejection. According to the results it seems that these adolescents experience problematic relationships, they have a low self-image and also experience feelings of anxiety and a sense of inferiority. / Psychology of Education / M. Ed. (Sielkundige Opvoedkunde)

Although the short-term outcomes of solid allograft survival have improved substantially over the last few decades, there has been no significant improvement in long-term survival of solid allografts. This thesis presents the initial characterisation of alloantibody mediated rejection in a murine heart transplant model, with particular focus on the impact of the different phases of the humoral alloimmune response (follicular or germinal centre) on graft rejection.

published_or_final_version / Psychology / Master / Master of Philosophy

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No description available.

No description available.