Back to Search
Start Over
Effect of Early Immunosuppression Therapy on De Novo Anti–Human-Leukocyte-Antigen Antibody After Kidney Transplantation
- Source :
- Transplantation Proceedings. 50:2382-2387
- Publication Year :
- 2018
- Publisher :
- Elsevier BV, 2018.
-
Abstract
- The aim of the study was to investigate the effect of immunosuppression therapy early after kidney transplantation, particularly exposure of mycophenolic acid (MPA) and calcineurin inhibitor (CNI), on posttransplantation de novo HLA antibody production. Methods A single-center retrospective cohort study was performed at the First Affiliated Hospital of Sun Yat-sen University, enrolling the kidney transplant or pancreas-kidney transplant recipients who had surgery between January 2010 and February 2016. Results A total of 214 recipients were included in the study with a median follow-up period of 1.06 years. A total of 30 recipients (14.0%) were positive in HLA antibody detection posttransplant with a median follow-up period of 1.46 years. Ten recipients (4.7%) lost their allograft function during follow-up, and 6 of them (60%) developed de novo HLA antibody after graft failure. Multivariate analysis showed that acute rejection significantly increased the risk of de novo HLA antibody (hazard ratio [HR], 2.732). Intensified MPA dosing therapy reduced the risk by 59.8% (HR, 0.402); low-dose CNI therapy increased the risk by 33.3% (HR, 1.333), and the effect of extremely low-dose CNI therapy was even larger (HR, 2.242). Conclusion The risk of de novo HLA antibody can be decreased by reducing the risk of acute rejection. A tendency was seen in low-dose CNI therapy to increase the risk of de novo HLA antibody, but intensified MPA dosing therapy may provide an umbrella protection effect by reducing the risk. Prospective study was required to confirm the effects.
- Subjects :
- Adult
Graft Rejection
Male
medicine.medical_specialty
medicine.medical_treatment
030232 urology & nephrology
030230 surgery
Gastroenterology
Mycophenolic acid
Cohort Studies
03 medical and health sciences
0302 clinical medicine
HLA Antigens
Internal medicine
medicine
Humans
Transplantation, Homologous
Dosing
Prospective cohort study
Kidney transplantation
Autoantibodies
Retrospective Studies
Transplantation
business.industry
Graft Survival
Hazard ratio
Retrospective cohort study
Immunosuppression
Mycophenolic Acid
medicine.disease
Kidney Transplantation
Calcineurin
Female
Surgery
business
Immunosuppressive Agents
medicine.drug
Subjects
Details
- ISSN :
- 00411345
- Volume :
- 50
- Database :
- OpenAIRE
- Journal :
- Transplantation Proceedings
- Accession number :
- edsair.doi.dedup.....aacbdc00a5f174b22cf0e8a095f5542f