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Kidney graft recipients with pretransplantation HLA CLASS I antibodies and high soluble CD30 are at high risk for graft loss

Authors :
Caner Süsal
Mario Arbelaez
Luis F. García
Libia M. Rodríguez
José Miguel Cotes
Sara C. París
Yolanda Torres
Source :
Human Immunology. 68:652-660
Publication Year :
2007
Publisher :
Elsevier BV, 2007.

Abstract

In the present study, we investigated whether pretransplantation HLA class I and class II antibodies and pretransplantation levels of soluble CD30 (sCD30) and IgA anti-Fab autoantibodies are predictive of kidney allograft survival. Pretransplantation sera of 504 deceased-donor kidney recipients were tested for IgG HLA class I and class II antibodies, sCD30, and IgA anti-Fab levels using the CTS 4 ELISA kit. Kidney graft survival was estimated by Kaplan-Meier method and multivariate Cox regression. Regardless of the presence of HLA class II antibodies, recipients with high HLA class I reactivity had lower 1-year graft survival than recipients with low reactivity (p < 0.01). Recipients with high sCD30 had lower 5-year graft survival rate than those with low sCD30 (p < 0.01). The sCD30 effect was observed in presensitized and nonsensitized recipients, demonstrated a synergistic effect with HLA class I antibodies (p < 0.001), and appeared to be neutralized in recipients with no HLA class II mismatches. IgA anti-Fab did not influence kidney graft survival. Our results indicate that high pretransplantation sCD30 levels and HLA class I positivity increase the risk of kidney graft loss regardless of other factors. Consequently, such determinations should be routinely performed to estimate recipients' risks of graft rejection before transplantation.

Details

ISSN :
01988859
Volume :
68
Database :
OpenAIRE
Journal :
Human Immunology
Accession number :
edsair.doi.dedup.....c65e3ce3cdcda19cd2a0df143c1e56a8
Full Text :
https://doi.org/10.1016/j.humimm.2007.05.004