@article{3122236,
    title = "Impact of primary disease nature in the development of de novo donor-specific antibodies after kidney transplant and the risk of acute rejection",
    author = "Lionaki, S. and Pappas, A. and Altanis, N. and Kapsia, H. and Liapis, G. and Vittoraki, A. and Iniotaki, A. and Zavos, G. and Boletis, J.N.",
    journal = "Experimental and Clinical Transplantation",
    year = "2019",
    volume = "17",
    number = "3",
    pages = "304-312",
    publisher = "Baskent University",
    doi = "10.6002/ect.2018.0054",
    keywords = "HLA antibody;  HLA antigen class 2;  antibody, acute graft rejection;  adult;  alloimmunity;  antibody detection;  antibody production;  antibody titer;  Article;  autoimmunity;  cohort analysis;  controlled study;  female;  follow up;  graft failure;  graft recipient;  graft survival;  human;  human cell;  incidence;  kidney biopsy;  kidney donor;  kidney graft;  long term survival;  major clinical study;  male;  retrospective study;  risk;  acute disease;  blood;  donor;  graft rejection;  histocompatibility;  immunology;  kidney transplantation;  middle aged;  risk assessment, Acute Disease;  Adult;  Antibodies;  Female;  Graft Rejection;  Humans;  Kidney Transplantation;  Male;  Middle Aged;  Retrospective Studies;  Risk Assessment;  Tissue Donors;  Transplantation Immunology",
    abstract = "Objectives: In this study, we explored the effect of the primary disease nature on development of de novo donor-specific antibodies after kidney transplant. Materials and Methods: We retrospectively studied kidney transplant recipients based on their primary disease. Patients were divided according to autoimmune and nonautoimmune diseases. The frequency of de novo donor-specific antibodies posttransplant and the incidence of acute rejection were estimated. De novo donor-specific antibodies were determined by the Luminex (LAB Screen products, One Lambda, Inc., Canoga Park, CA, USA) assay. Results: Our study included 228 patients: 92 with autoimmune diseases and 136 with nonautoimmune diseases. Similar rates of de novo donor-specific antibodies (10.9% vs 11.8%; P = .835) were shown in the 2 groups over a mean (standard deviation) followup of 56.5 (27.8) months. In the nonautoimmune group, presence of de novo donor-specific antibodies was associated with higher rates of biopsy-proven acute rejection (37.5% vs 8.3%; odds ratio = 6.6; 95% confidence interval, 1.985-21.945; P = .002) versus that shown in patients of the same group without de novo donor-specific antibodies. In the autoimmune group, biopsy-proven acute rejection rates were similar between patients with and without de novo donorspecific antibodies. Mean fluorescence intensity titers of de novo donor-specific antibodies were significantly higher in patients with nonautoimmune primary disease (P = .003). Overall, graft loss was shown to be significantly higher in patients with autoimmune than in patients with nonautoimmune diseases (P < .001), although not different between patients with de novo donor-specific antibody formation (P = .677). Conclusions: No associations were shown between the frequency of de novo donor-specific antibody development after kidney transplant and the nature of the primary disease (autoimmune vs nonauto immune). Detection of de novo donor-specific antibodies was associated with higher rates of biopsy-proven acute rejection among patients with nonautoimmune primary disease. © Başkent University 2019 Printed in Turkey. All Rights Reserved."
}