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. 2018 Jul 6:23:457-466.
doi: 10.12659/AOT.908491.

Effect of Preformed or De Novo Anti-HLA Antibodies on Function and Graft Survival in Kidney Transplant Recipients

Marcos Vinicius de Sousa  1 , Ana Claudia Gonçalez  2 , Ricardo de Lima Zollner  3 , Marilda Mazzali  1
Affiliations

Effect of Preformed or De Novo Anti-HLA Antibodies on Function and Graft Survival in Kidney Transplant Recipients

Marcos Vinicius de Sousa et al. Ann Transplant. .

Abstract

BACKGROUND Donor-specific antibodies (DSA), directed against human leucocyte antigens (HLA), are associated with increased risk for graft rejection in kidney transplantation. Anti-HLA antibodies detection by Luminex™ present high sensitivity and accuracy, but its interpretation after transplantation is not completely clear. The aim of this study was to evaluate the impact of anti-HLA antibodies, preformed or de novo, on renal function, graft survival, and incidence of antibody-mediated acute rejection (AMR). MATERIAL AND METHODS A retrospective cohort of 86 kidney transplant recipients was divided into 3 groups according to the presence of anti-HLA antibodies before transplantation: donor-specific antibodies (DSA+, n=15), non-DSA (non-DSA, n=39), and negative pre-transplant panel reactive antibodies (PRA) that became positive after transplantation (PRA-, n=22). Forty-nine recipients with negative PRA pre- and post-transplantation were excluded. Antibody specificity and intensity of fluorescence (MFI) and their relationship with renal function, proteinuria, AMR, and graft failure were evaluated. RESULTS Among patients who completed 1 year of follow-up, there was no significant difference in serum creatinine, estimated glomerular filtration rate, or proteinuria. AMR incidence was 9.5% in the DSA group, 2.3% in the non-DSA group, and 9.1% in the PRA- group. There was no correlation between fluorescence intensity and/or antibodies class (I or II) with increased risk of AMR. Thirteen grafts failed within 1 year post-transplant, there were 9 deaths due to infection, and only 1 due to AMR (PRA- group, DSA de novo at 3 months). CONCLUSIONS In contrast to previous reports, we did not find a correlation between incidence of AMR and MFI intensity in this series.

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Conflict of interest statement

Conflict of interest

None.

Figures

Figure 1
Figure 1
Study population and analyzed groups.
Figure 2
Figure 2
Mean estimated glomerular filtration rate (eGFR) (ml/min/1.73 m2), according to the groups, over time after renal transplantation.
Figure 3
Figure 3
Distribution of renal transplant recipients with donor-specific anti-HLA antibodies (A) and non-donor-specific antibodies (B), according to the groups, after renal transplantation.
Figure 4
Figure 4
(A–C) Mean and amplitude of sum of DSA values (MFI), according to the groups, after renal transplantation.
Figure 5
Figure 5
Death-censored kidney graft survival of patients according anti-HLA antibodies before transplantation (donor-specific antibodies: DSA+, non-DSA, without anti-HLA antibodies: PRA−).
See this image and copyright information in PMC

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References

    1. Mackay IR, Rosen FS, Klein J, Sato A. The HLA system. N Engl J Med. 2000;343(10):702–9. - PubMed
    1. Malheiro J, Tafulo S, Dias L, et al. Analysis of preformed donor-specific anti-HLA antibodies characteristics for prediction of antibody-mediated rejection in kidney transplantation. Transpl Immunol. 2015;32(2):66–71. - PubMed
    1. Khovanova N, Daga S, Shaikhina T, et al. Subclass analysis of donor HLA-specific IgG in antibody-incompatible renal transplantation reveals a significant association of IgG4 with rejection and graft failure. Transpl Int. 2015;28(12):1405–15. - PMC - PubMed
    1. Jordan SC, Vo AA. Donor-specific antibodies in allograft recipients: Etiology, impact and therapeutic approaches. Curr Opin Organ Transplant. 2014;19(6):591–97. - PubMed
    1. Gosset C, Lefaucheur C, Glotz D. New insights in antibody-mediated rejection. Curr Opin Nephrol Hypertens. 2014;23(6):597–604. - PubMed