1. Impact of preformed donor-specific antibodies against HLA class I on kidney graft outcomes: Comparative analysis of exclusively anti-Cwvsanti-A and/or -B antibodies
- Author
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Sofia Santos, Rute Carmo, Sofia Pedroso, Susana Sampaio, Sandra Tafulo, Castro Henriques, Jorge Malheiro, Andreia Campos, Leonídio Dias, Marta Costa, La Salete Martins, António Cabrita, and Manuela Guedes de Almeida
- Subjects
030232 urology & nephrology ,Human leukocyte antigen ,030230 surgery ,03 medical and health sciences ,0302 clinical medicine ,Retrospective Cohort Study ,Medicine ,Transplantation ,Kidney ,biology ,Solid-phase immunoassays ,business.industry ,Donor-specific antibodies ,Donor specific antibodies ,Panel reactive antibody ,Anti human leukocyte antigen class I ,Graft survival ,Virology ,body regions ,medicine.anatomical_structure ,Antibody-mediated rejection ,Immunology ,Antibody mediated rejection ,AntiHLA-Cw antibodies ,biology.protein ,Antibody ,business - Abstract
AIM: To analyze the clinical impact of preformed antiHLA-Cw vs antiHLA-A and/or -B donor-specific antibodies (DSA) in kidney transplantation. METHODS: Retrospective study, comparing 12 patients transplanted with DSA exclusively antiHLA-Cw with 23 patients with preformed DSA antiHLA-A and/or B. RESULTS: One year after transplantation there were no differences in terms of acute rejection between the two groups (3 and 6 cases, respectively in the DSA-Cw and the DSA-A-B groups; P = 1). At one year, eGFR was not significantly different between groups (median 59 mL/min in DSA-Cw group, compared to median 51 mL/min in DSA-A-B group, P = 0.192). Moreover, kidney graft survival was similar between groups at 5-years (100% in DSA-Cw group vs 91% in DSA-A-B group, P = 0.528). The sole independent predictor of antibody mediated rejection (AMR) incidence was DSA strength (HR = 1.07 per 1000 increase in MFI, P = 0.034). AMR was associated with shortened graft survival at 5-years, with 75% and 100% grafts surviving in patients with or without AMR, respectively (Log-rank P = 0.005). CONCLUSION: Our data indicate that DSA-Cw are associated with an identical risk of AMR and impact on graft function in comparison with "classical" class I DSA. info:eu-repo/semantics/publishedVersion
- Published
- 2016