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A paired kidney analysis on the impact of pre-transplant anti-HLA antibodies on graft survival.
Michielsen, Laura A; Wisse, Bram W; Kamburova, Elena G; Verhaar, Marianne C; Joosten, Irma; Allebes, Wil A; van der Meer, Arnold; Hilbrands, Luuk B; Baas, Marije C; Spierings, Eric; Hack, Cornelis E; van Reekum, Franka E; Bots, Michiel L; Drop, Adriaan C A D; Plaisier, Loes; Seelen, Marc A J; Sanders, Jan-Stephan F; Hepkema, Bouke G; Lambeck, Annechien J; Bungener, Laura B; Roozendaal, Caroline; Tilanus, Marcel G J; Voorter, Christien E; Wieten, Lotte; van Duijnhoven, Elizabeth M; Gelens, Mariëlle; Christiaans, Maarten H L; van Ittersum, Frans J; Nurmohamed, Shaikh A; Lardy, Neubury M; Swelsen, Wendy; van der Pant, Karlijn A; van der Weerd, Neelke C; Ten Berge, Ineke J M; Bemelman, Frederike J; Hoitsma, Andries; van der Boog, Paul J M; de Fijter, Johan W; Betjes, Michiel G H; Heidt, Sebastiaan; Roelen, Dave L; Claas, Frans H; Otten, Henderikus G; van Zuilen, Arjan D.
Afiliação
  • Michielsen LA; Department of Nephrology and Hypertension, University Medical Center Utrecht, Utrecht University, Utrecht, The Netherlands.
  • Wisse BW; Laboratory of Translational Immunology, University Medical Center Utrecht, Utrecht University, Utrecht, The Netherlands.
  • Kamburova EG; Laboratory of Translational Immunology, University Medical Center Utrecht, Utrecht University, Utrecht, The Netherlands.
  • Verhaar MC; Department of Nephrology and Hypertension, University Medical Center Utrecht, Utrecht University, Utrecht, The Netherlands.
  • Joosten I; Laboratory Medicine, Lab Medical Immunology, Radboud University Medical Center, Nijmegen, The Netherlands.
  • Allebes WA; Laboratory Medicine, Lab Medical Immunology, Radboud University Medical Center, Nijmegen, The Netherlands.
  • van der Meer A; Laboratory Medicine, Lab Medical Immunology, Radboud University Medical Center, Nijmegen, The Netherlands.
  • Hilbrands LB; Department of Nephrology, Radboud University Medical Center, Radboud Institute for Health Sciences, Nijmegen, The Netherlands.
  • Baas MC; Department of Nephrology, Radboud University Medical Center, Radboud Institute for Health Sciences, Nijmegen, The Netherlands.
  • Spierings E; Laboratory of Translational Immunology, University Medical Center Utrecht, Utrecht University, Utrecht, The Netherlands.
  • Hack CE; Laboratory of Translational Immunology, University Medical Center Utrecht, Utrecht University, Utrecht, The Netherlands.
  • van Reekum FE; Department of Nephrology and Hypertension, University Medical Center Utrecht, Utrecht University, Utrecht, The Netherlands.
  • Bots ML; Julius Center for Health Sciences and Primary Care, University Medical Center Utrecht, Utrecht University, Utrecht, The Netherlands.
  • Drop ACAD; Laboratory of Translational Immunology, University Medical Center Utrecht, Utrecht University, Utrecht, The Netherlands.
  • Plaisier L; Laboratory of Translational Immunology, University Medical Center Utrecht, Utrecht University, Utrecht, The Netherlands.
  • Seelen MAJ; Department of Nephrology, University of Groningen, University Medical Center Groningen, Groningen, The Netherlands.
  • Sanders JF; Department of Nephrology, University of Groningen, University Medical Center Groningen, Groningen, The Netherlands.
  • Hepkema BG; Department of Laboratory Medicine, University of Groningen, University Medical Center Groningen, Groningen, The Netherlands.
  • Lambeck AJ; Department of Laboratory Medicine, University of Groningen, University Medical Center Groningen, Groningen, The Netherlands.
  • Bungener LB; Department of Laboratory Medicine, University of Groningen, University Medical Center Groningen, Groningen, The Netherlands.
  • Roozendaal C; Department of Laboratory Medicine, University of Groningen, University Medical Center Groningen, Groningen, The Netherlands.
  • Tilanus MGJ; Department of Transplantation Immunology, Tissue Typing Laboratory, Maastricht University Medical Center, Maastricht, The Netherlands.
  • Voorter CE; Department of Transplantation Immunology, Tissue Typing Laboratory, Maastricht University Medical Center, Maastricht, The Netherlands.
  • Wieten L; Department of Transplantation Immunology, Tissue Typing Laboratory, Maastricht University Medical Center, Maastricht, The Netherlands.
  • van Duijnhoven EM; Department of Internal Medicine, Division of Nephrology, Maastricht University Medical Center, Maastricht, The Netherlands.
  • Gelens M; Department of Internal Medicine, Division of Nephrology, Maastricht University Medical Center, Maastricht, The Netherlands.
  • Christiaans MHL; Department of Internal Medicine, Division of Nephrology, Maastricht University Medical Center, Maastricht, The Netherlands.
  • van Ittersum FJ; Department of Nephrology, Amsterdam University Medical Center, VU University Medical Center, Amsterdam, The Netherlands.
  • Nurmohamed SA; Department of Nephrology, Amsterdam University Medical Center, VU University Medical Center, Amsterdam, The Netherlands.
  • Lardy NM; Department of Immunogenetics, Sanquin, Amsterdam, The Netherlands.
  • Swelsen W; Department of Immunogenetics, Sanquin, Amsterdam, The Netherlands.
  • van der Pant KA; Renal Transplant Unit, Department of Internal Medicine, Amsterdam UMC, Academic Medical Center, Amsterdam, The Netherlands.
  • van der Weerd NC; Renal Transplant Unit, Department of Internal Medicine, Amsterdam UMC, Academic Medical Center, Amsterdam, The Netherlands.
  • Ten Berge IJM; Renal Transplant Unit, Department of Internal Medicine, Amsterdam UMC, Academic Medical Center, Amsterdam, The Netherlands.
  • Bemelman FJ; Renal Transplant Unit, Department of Internal Medicine, Amsterdam UMC, Academic Medical Center, Amsterdam, The Netherlands.
  • Hoitsma A; Dutch Organ Transplant Registry (NOTR), Dutch Transplant Foundation (NTS), Leiden, The Netherlands.
  • van der Boog PJM; Department of Nephrology, Leiden University Medical Center, Leiden, The Netherlands.
  • de Fijter JW; Department of Nephrology, Leiden University Medical Center, Leiden, The Netherlands.
  • Betjes MGH; Department of Nephrology, Rotterdam, The Netherlands.
  • Heidt S; Department of Immunohematology and Blood Transfusion, Leiden University Medical Center, Leiden, The Netherlands.
  • Roelen DL; Department of Immunohematology and Blood Transfusion, Leiden University Medical Center, Leiden, The Netherlands.
  • Claas FH; Department of Immunohematology and Blood Transfusion, Leiden University Medical Center, Leiden, The Netherlands.
  • Otten HG; Laboratory of Translational Immunology, University Medical Center Utrecht, Utrecht University, Utrecht, The Netherlands.
  • van Zuilen AD; Department of Nephrology and Hypertension, University Medical Center Utrecht, Utrecht University, Utrecht, The Netherlands.
Nephrol Dial Transplant ; 34(6): 1056-1063, 2019 06 01.
Article em En | MEDLINE | ID: mdl-30365008
BACKGROUND: Pre-transplant donor-specific anti-human leucocyte antigen (HLA) antibodies (DSAs) are associated with impaired kidney graft survival while the clinical relevance of non-donor-specific anti-HLA antibodies (nDSAs) is more controversial. The aim of the present paired kidney graft study was to compare the clinical relevance of DSAs and nDSAs. METHODS: To eliminate donor and era-dependent factors, a post hoc paired kidney graft analysis was performed as part of a Dutch multicentre study evaluating all transplantations between 1995 and 2005 with available pre-transplant serum samples. Anti-HLA antibodies were detected with a Luminex single-antigen bead assay. RESULTS: Among 3237 deceased donor transplantations, we identified 115 recipient pairs receiving a kidney from the same donor with one recipient being DSA positive and the other without anti-HLA antibodies. Patients with pre-transplant DSAs had a significantly lower 10-year death-censored graft survival (55% versus 82%, P=0.0001). We identified 192 pairs with one recipient as nDSA positive (against Class I and/or II) and the other without anti-HLA antibodies. For the patients with nDSAs against either Class I or II, graft survival did not significantly differ compared with patients without anti-HLA antibodies (74% versus 77%, P = 0.79). Only in patients with both nDSAs Class I and II was there a trend towards a lower graft survival (58%, P = 0.06). Lastly, in a small group of 42 recipient pairs, 10-year graft survival in recipients with DSAs was 49% compared with 68% in recipients with nDSAs (P=0.11). CONCLUSION: This paired kidney analysis confirms that the presence of pre-transplant DSAs in deceased donor transplantations is a risk marker for graft loss, whereas nDSAs in general are not associated with a lower graft survival. Subgroup analysis indicated that only in broadly sensitized patients with nDSAs against Class I and II, nDSAs may be a risk marker for graft loss in the long term.
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Texto completo: 1 Base de dados: MEDLINE Assunto principal: Rejeição de Enxerto / Sobrevivência de Enxerto / Antígenos HLA / Isoanticorpos Tipo de estudo: Clinical_trials / Etiology_studies / Prognostic_studies / Risk_factors_studies Limite: Adult / Female / Humans / Male / Middle aged País como assunto: Europa Idioma: En Ano de publicação: 2019 Tipo de documento: Article
Texto completo
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Texto completo: 1 Base de dados: MEDLINE Assunto principal: Rejeição de Enxerto / Sobrevivência de Enxerto / Antígenos HLA / Isoanticorpos Tipo de estudo: Clinical_trials / Etiology_studies / Prognostic_studies / Risk_factors_studies Limite: Adult / Female / Humans / Male / Middle aged País como assunto: Europa Idioma: En Ano de publicação: 2019 Tipo de documento: Article