Nancy Reinsmoen, PhD
Director, HLA Laboratory
|Medical Genetics Research Institute|
Awards and Activities
|United Network for Organ Sharing (UNOS), Board of Directors Member||1993 - 1995|
|ASHI, President||1993 - 1994|
|United Network for Organ Sharing (UNOS), Executive Board of Directors||1994 - 1995|
Solid organ recipient long term graft outcome has not improved due to the continual process of chronic rejection. A major risk factor for chronic rejection is acute rejection episodes. The research focus is to identify immune factors that predict early acute rejection. Pretransplant identification of immune status risk factors can alert the physicians and surgeons as to those patients at high risk for early acute rejection episodes thereby allowing for therapeutic means of intervention aimed at avoiding these graft dysfunction.
A major focus of these studies has been to increase the likelihood of patients who have been sensitized to HLA via pregnancies, transfusions, or prior transplants to receive another transplanted organ. The virtual crossmatch (identifying unacceptable antigens in the potential donor pool by a fine specificity analysis of the patient's antibody status) has been used to increase transplantation for heart and lung recipients. Identifying acceptable levels of antibody binding intensity that will decrease the risk for early antibody mediated acute rejection has allowed for the transplantation of highly sensitized kidney recipients.
Current investigations include:
Multiple immune parameters including BAFF, sCD30, granzyme B, perforin, and various cytokines and chemokines are being measured to determine if acute rejection episodes can be predicted. Posttransplant monitoring of antibody specificity and strength is being undertaken to determine individual patients' risk for immune complication. Innovative measures to quantitate the antibody mediated immune response are being explored.
- Appel JZ, Hartwig MG, Cantu E, Palmer SM, Reinsmoen NL, Davis RD: Role of flow cytometry to define unacceptable HLA antigens in lung transplant recipients with HLA-specific antibodies. Transplantation, 81(7): 1049-57, 2006
- Palmer SM, Burch LH, Mir S, Smith SR, Kuo PC, Herczyk WF, Reinsmoen NL, Schwartz DA: Donor polymorphisms in Toll-like receptor-4 influence the development of rejection after renal transplantation. Clinical transplantation, 20(1): 30-6
- Palmer SM, Klimecki W, Yu L, Reinsmoen NL, Snyder LD, Ganous TM, Burch L, Schwartz DA: Genetic regulation of rejection and survival following human lung transplantation by the innate immune receptor CD14. Am. J. Transplant., 7(3): 693-9, 2007
- Vo AA, Lukovsky M, Toyoda M, Wang J, Reinsmoen NL, Lai CH, Peng A, Villicana R, Jordan SC: Rituximab and intravenous immune globulin for desensitization during renal transplantation. N. Engl. J. Med., 359(3): 242-51, 2008
- Vo AA, Wechsler EA, Wang J, Peng A, Toyoda M, Lukovsky M, Reinsmoen N, Jordan SC: Analysis of subcutaneous (SQ) alemtuzumab induction therapy in highly sensitized patients desensitized with IVIG and rituximab. Am. J. Transplant., 8(1): 144-9, 2007
- Reinsmoen NL, Cornett KM, Kloehn R, Burnette AD, McHugh L, Flewellen BK, Matas A, Savik K: Pretransplant donor-specific and non-specific immune parameters associated with early acute rejection. Transplantation, 85(3): 462-70, 2008