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Dynamics of anti-human leukocyte antigen antibodies after renal transplantation and their impact on graft outcome.
de Souza, Patrícia Soares; David-Neto, Elias; Panajotopolous, Nicolas; Agena, Fabiana; Rodrigues, Hélcio; Ronda, Carla; David, Daísa Ribeiro; Kalil, Jorge; Nahas, Wiliam Carlos; de Castro, Maria Cristina Ribeiro.
Afiliação
  • de Souza PS; Renal Transplantation Service of Urology Division, Hospital das Clínicas de São Paulo, Sao Paulo University, Sao Paulo, Brazil; Nephrology Department, Hospital das Clínicas de São Paulo, Sao Paulo University, Sao Paulo, Brazil.
Clin Transplant ; 28(11): 1234-43, 2014 Nov.
Article em En | MEDLINE | ID: mdl-25142061
The purpose of this study was to sequentially monitor anti-HLA antibodies and correlate the results with antibody-mediated rejection (AMR), graft survival (GS), and graft function (GF). We collected sera from 111 kidney transplant recipients on transplant days 0, 7, 14, 30, 60, 90, 180, and 360 and analyzed PRA levels by ELISA. DSAs were analyzed by single-antigen beads in rejecting kidneys. At pre-transplant, 79.3% of the patients were non-sensitized (PRA = 0%) and 20.7% were sensitized (PRA > 1%). After transplant, patients were grouped by PRA profile: no anti-HLA antibodies pre- or post-transplant (group HLApre-/post-; n = 80); de novo anti-HLA antibodies post-transplant (group HLApre-/post+; n = 8); sensitized pre-transplant/increased PRA post-transplant (group HLApre+/post↑; n = 9); and sensitized pre-transplant/decreased PRA post-transplant (group HLApre+/post↓; n = 14). De novo anti-HLA antibodies were detected at 7-180 d. In sensitized patients, PRA levels changed within the first 30 d post-transplant. Incidence of AMR was higher in HLApre-/post+ and HLApre+/post↑ than in HLApre-/post-, and HLApre+/post↓ (p < 0.001) groups. One-yr death-censored GS was 36% in group HLApre+/post↑, compared with 98%, 88% and 100% in groups HLApre-/post-, HLApre-/post+, and HLApre+/post↓, respectively (p < 0.001). Excluding first-year graft losses, GF and GS were similar among the groups. In conclusion, post-transplant antibody monitoring can identify recipients at higher risk of AMR.
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Texto completo: 1 Coleções: 01-internacional Base de dados: MEDLINE Assunto principal: Transplante de Rim / Rejeição de Enxerto / Sobrevivência de Enxerto / Antígenos HLA / Falência Renal Crônica / Anticorpos Tipo de estudo: Etiology_studies / Incidence_studies / Observational_studies / Prognostic_studies / Risk_factors_studies Limite: Adult / Female / Humans / Male / Middle aged Idioma: En Revista: Clin Transplant Assunto da revista: TRANSPLANTE Ano de publicação: 2014 Tipo de documento: Article País de afiliação: Brasil País de publicação: Dinamarca
Texto completo
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Texto completo: 1 Coleções: 01-internacional Base de dados: MEDLINE Assunto principal: Transplante de Rim / Rejeição de Enxerto / Sobrevivência de Enxerto / Antígenos HLA / Falência Renal Crônica / Anticorpos Tipo de estudo: Etiology_studies / Incidence_studies / Observational_studies / Prognostic_studies / Risk_factors_studies Limite: Adult / Female / Humans / Male / Middle aged Idioma: En Revista: Clin Transplant Assunto da revista: TRANSPLANTE Ano de publicação: 2014 Tipo de documento: Article País de afiliação: Brasil País de publicação: Dinamarca