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Impact of persistent and cleared preformed HLA DSA on kidney transplant outcomes

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dc.contributor.author Redondo Pachón, María Dolores
dc.contributor.author Pérez-Sáez, María José
dc.contributor.author Mir Fontana, M. Luisa
dc.contributor.author Gimeno Beltran, Javier
dc.contributor.author Llinàs-Mallol, Laura
dc.contributor.author García, Carmen
dc.contributor.author Hernández, Juan José
dc.contributor.author Yélamos López, José
dc.contributor.author Pascual Santos, Julio
dc.contributor.author Crespo Barrio, Marta
dc.date.accessioned 2018-11-19T08:54:29Z
dc.date.issued 2018
dc.identifier.citation Redondo-Pachón D, Pérez-Sáez MJ, Mir M, Gimeno J, Llinás L, García C. et al. Impact of persistent and cleared preformed HLA DSA on kidney transplant outcomes. Hum Immunol. 2018 Jun;79(6):424-431. DOI: 10.1016/j.humimm.2018.02.014
dc.identifier.issn 0198-8859
dc.identifier.uri http://hdl.handle.net/10230/35785
dc.description.abstract Preformed HLA donor-specific antibodies (DSA) only detected with Luminex have been associated with increased risk of antibody-mediated rejection (ABMR) and graft failure after kidney transplantation (KT). Their evolution after KT may modify this risk. We analyzed postransplant evolution of preformed DSA identified retrospectively and their impact on outcomes of 370 KT performed 2006-2014. Antibodies were monitored prospectively at 1-3-5 years after KT and if any dysfunction. Early acute ABMR was more frequent among patients with preformed DSA class-I or I + II than isolated class-II (29.4% vs 4.5%, p = 0.02). One year post-KT, 20 of 34 patients with functioning KT had persistent DSA. Preformed DSA class-II persisted more frequently than class-I/I + II (66.7% vs 33.3%; p = 0.031). The only risk factor independently associated with persistence was pretransplant MFI. Patients with de novo DSA had the highest risk of ABMR (HR 22.2 [CI 6.1-81.2]). Although recipients with persisting preformed DSA had significantly increased ABMR risk (HR 14.7 [CI 6.5-33.0]), those with cleared preformed DSA also had a higher risk than those without DSA (HR 7.01 [CI 2.2-21.8]). Preformed DSA are a very important risk factor for ABMR and graft loss. Patients who clear preformed DSA still show an increased risk of ABMR and graft loss after KT
dc.format.mimetype application/pdf
dc.language.iso eng
dc.publisher Elsevier
dc.relation.ispartof Human Immunology. 2018 Jun;79(6):424-31
dc.rights © Elsevier http://dx.doi.org/10.1016/j.humimm.2018.02.014
dc.subject.other Ronyons -- Trasplantació
dc.title Impact of persistent and cleared preformed HLA DSA on kidney transplant outcomes
dc.type info:eu-repo/semantics/article
dc.identifier.doi http://dx.doi.org/10.1016/j.humimm.2018.02.014
dc.subject.keyword Antibody-mediated rejection
dc.subject.keyword Donor-specific antibodies
dc.subject.keyword Kidney transplantation
dc.subject.keyword Preformed
dc.rights.accessRights info:eu-repo/semantics/openAccess
dc.type.version info:eu-repo/semantics/acceptedVersion


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