Pre-existing donor-specific antibodies are detrimental to kidney allograft only when persistent after transplantation.
Transpl Int
; 30(1): 29-40, 2017 Jan.
Article
in En
| MEDLINE
| ID: mdl-27678382
ABSTRACT
Donor-specific antibodies (DSA) increase the risk of allograft rejection and graft failure. They may be present before transplant or develop de novo after transplantation. Here, we studied the evolution of preformed DSA and their impact on graft outcome in kidney transplant recipients. Using the Luminex Single Antigen assay, we analyzed the sera on the day of transplantation of 239 patients who received a kidney transplant. Thirty-seven patients (15.5%) had pre-existing DSA detected the day of transplantation. After 5 years, the pre-existing DSA disappeared in 22 patients whereas they persisted in 12. Variables associated with DSA persistence were age <50 years (P = 0.009), a history of previous transplantation (P = 0.039), the presence of class II DSA (P = 0.009), an MFI of preformed DSA >3500 (P < 0.001), and the presence of two or more DSA (P < 0.001). DSA persistence was associated with a higher risk of graft loss and antibody-mediated rejection. Previously undetected preformed DSA are deleterious to graft survival only when they persist after transplantation.
Key words
Full text:
1
Collection:
01-internacional
Database:
MEDLINE
Main subject:
Tissue Donors
/
Kidney Transplantation
/
Renal Insufficiency
/
Isoantibodies
Type of study:
Diagnostic_studies
/
Etiology_studies
/
Observational_studies
/
Prognostic_studies
/
Risk_factors_studies
Limits:
Adult
/
Female
/
Humans
/
Male
/
Middle aged
Language:
En
Journal:
Transpl Int
Journal subject:
TRANSPLANTE
Year:
2017
Document type:
Article
Affiliation country:
France