Back to Search
Start Over
Single antigen testing to reduce early antibody-mediated rejection risk in female recipients of a spousal donor kidney
- Source :
- Transplant Immunology
- Publication Year :
- 2021
- Publisher :
- Elsevier BV, 2021.
-
Abstract
- Female recipients of a spousal donor kidney transplant are at greater risk of donor-specific pre-immunization, which may increase the risk of acute antibody-mediated rejection (ABMR). We assessed the incidence of early ABMR (within two weeks after transplantation), risk factors for ABMR and graft function in 352 complement-dependent cytotoxicity test-negative LURD transplant recipients, transplanted between 1997 and 2014 at the Leiden University Medical Center in The Netherlands. Risk factors for immunization were retrieved from the health records. As methods to screen for preformed donor-specific antibodies (pDSA) have developed through time, we retrospectively screened those with ABMR for pDSA using pooled-antigen bead (PAB) and single-antigen bead (SAB) assays. The cumulative incidence of rejection in the first six months after transplantation was 18% (TCMR 15%; early ABMR 3%). Early ABMR resulted in inferior graft survival and was more common in women who received a kidney from their spouse (10%) than in other women (2%) and men (1%). The SAB assay retrospectively identified pDSA in seven of nine cases of early ABMR (78%), while the PAB detected pDSA in only three cases (33%). Seeing that early ABMR occurred in 10% of women who received a kidney from their spouse, a SAB assay should be included in the pre-transplant assessment of this group of women, regardless of the result of the PAB assay.
- Subjects :
- Adult
Graft Rejection
Male
Risk
medicine.medical_specialty
Immunology
030230 surgery
Kidney
03 medical and health sciences
0302 clinical medicine
HLA Antigens
Isoantibodies
Internal medicine
medicine
Humans
Immunology and Allergy
Cumulative incidence
Spouses
Kidney transplantation
Aged
Transplantation
biology
business.industry
Histocompatibility Testing
Incidence (epidemiology)
Middle Aged
medicine.disease
Kidney Transplantation
Tissue Donors
medicine.anatomical_structure
Antibody mediated rejection
biology.protein
Female
Antibody
business
Donor kidney
030215 immunology
Subjects
Details
- ISSN :
- 09663274
- Volume :
- 67
- Database :
- OpenAIRE
- Journal :
- Transplant Immunology
- Accession number :
- edsair.doi.dedup.....565c20bb3611ed408da2912922da287d