We report the case of a 33 year-old female patient who started hemodialysis in 2009 because of end stage renal disease of unknown etiology. When she was registered on the transplant waiting list, she displayed a HLA sensitization related to 3 previous pregnancies. Her HLA antibodies Luminex profile remained stable from 2010 to 2014.

In March 2014, she underwent a fresh-frozen bone allograft for a femoral enchondroma. She didn't receive blood transfusions during this procedure, and there was no story of pregnancy. Three months after surgery she exhibited new HLA antibodies specificities. HLA typing of the bone donor revealed that these new HLA antibodies were specific of the donor antigens.

Fresh-frozen human bone allografts taken from femoral heads are used as filling material for large decaying orthopedic and dental surgery. However, the blood group or HLA type of the donors are usually not determined. Thus few studies have assessed HLA sensitization after bone allograft and, to date, there is no evidence of deleterious effect of HLA antibodies on the outcome of this surgery.

Our observation shows that a fresh-frozen bone allograft can induce a HLA sensitization and can jeopardize access to a subsequent renal transplantation. This therapeutic strategy should be avoided in patients waiting for kidney transplant unless there is no alternative.

CITATION INFORMATION: Bloch J, Elsermans V, Provôt F, Lionet A, Wajbrot-Houzé L, Noel C, Hazzan M. Bone Allograft: An Unusual Cause of Sensitization. Am J Transplant. 2016;16 (suppl 3).

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