the impact of pretransplant donor-specific antibodies on graft outcome in renal transplantation: a six-year follow-up study

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ID: 200734
2012
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Ranked #69 of 128 articles by views in icitacee 2015 - 2nd international conference on information technology, computer, and electrical engineering: green technology strengthening in information technology, electrical and computer engineering implementation, proceedings

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Abstract
OBJECTIVE: The significance of pretransplant, donor-specific antibodies on long-term patient outcomes is a subject of debate. This study evaluated the impact and the presence or absence of donor-specific antibodies after kidney transplantation on short- and long-term graft outcomes. METHODS: We analyzed the frequency and dynamics of pretransplant donor-specific antibodies following renal transplantation from a randomized trial that was conducted from 2002 to 2004 and correlated these findings with patient outcomes through 2009. Transplants were performed against a complement-dependent T- and B-negative crossmatch. Pre- and posttransplant sera were available from 94 of the 118 patients (80%). Antibodies were detected using a solid-phase (LuminexH), single-bead assay, and all tests were performed simultaneously. RESULTS: Sixteen patients exhibited pretransplant donor-specific antibodies, but only 3 of these patients (19%) developed antibody-mediated rejection and 2 of them experienced early graft losses. Excluding these 2 losses, 6 of 14 patients exhibited donor-specific antibodies at the final follow-up exam, whereas 8 of these patients (57%) exhibited complete clearance of the donor-specific antibodies. Five other patients developed ''de novo'' posttransplant donor-specific antibodies. Death-censored graft survival was similar in patients with pretransplant donor-specific and non-donor-specific antibodies after a mean follow-up period of 70 months. CONCLUSION: Pretransplant donor-specific antibodies with a negative complement-dependent cytotoxicity crossmatch are associated with a risk for the development of antibody-mediated rejection, although survival rates are similar when patients transpose the first months after receiving the graft. Our data also suggest that early posttransplant donor-specific antibody monitoring should increase knowledge of antibody dynamics and their impact on long-term graft outcome.
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Authors ;Elias David-Neto;Patricia Soares Souza;Nicolas Panajotopoulos;Helcio Rodrigues;Carlucci Gualberto Ventura;Daisa Silva Ribeiro David;Francine Brambate Carvalhinho Lemos;Fabiana Agena;William Carlos Nahas;Jorge Elias Kalil;Maria Cristina Ribeiro Castro
Journal icitacee 2015 - 2nd international conference on information technology, computer, and electrical engineering: green technology strengthening in information technology, electrical and computer engineering implementation, proceedings
Year 2012
DOI
10.6061/clinics/2012(04)09
URL
http://www.scielo.br/scielo.php?script=sci_arttext&pid=S1807-59322012000400009
Keywords
renal transplantation luminex donor-specific antibodies dsamedicine (general)

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