Τίτλος:
Impact of primary disease nature in the development of de novo donor-specific antibodies after kidney transplant and the risk of acute rejection
Γλώσσες Τεκμηρίου:
Αγγλικά
Περίληψη:
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.
Συγγραφείς:
Lionaki, S.
Pappas, A.
Altanis, N.
Kapsia, H.
Liapis, G.
Vittoraki, A.
Iniotaki, A.
Zavos, G.
Boletis, J.N.
Περιοδικό:
Experimental and Clinical Transplantation
Εκδότης:
Baskent University
Λέξεις-κλειδιά:
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
DOI:
10.6002/ect.2018.0054
