Alloantibodies specific for HLA class I molecules can mediate hyperacute rejection of kidney transplants. Explain under what conditions an individual would possess preexisting antibodies against HLA class I polymorphisms
What will be an ideal response?
If the individual has received a previous solid organ graft or blood transfusion that was not matched for HLA class I, a primary alloantibody response would have been mounted. Priming can also occur naturally during pregnancy when fetal cells bearing paternal HLA molecules enter the maternal circulatory system at birth. If the paternal HLA isoforms are different from the maternal isoforms, the mother will mount an anti-HLA alloantibody response. If a woman has multiple pregnancies with the same partner, her anti-HLA titer and memory B-cell population will increase. If a woman has multiple pregnancies with different partners who have disparate HLA allotypes, the diversity of anti-HLA antibody will also increase. Both scenarios restrict the number of possible donors for transplantation; unsuitable donors are eliminated from the list after cross-matching.
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