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.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.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.doi http://dx.doi.org/10.1016/j.humimm.2018.02.014
• dc.identifier.issn 0198-8859
• dc.identifier.uri http://hdl.handle.net/10230/35785
• 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.rights.accessRights info:eu-repo/semantics/openAccess
• dc.subject.keyword Antibody-mediated rejection
• dc.subject.keyword Donor-specific antibodies
• dc.subject.keyword Kidney transplantation
• dc.subject.keyword Preformed
• 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.type.version info:eu-repo/semantics/acceptedVersion