Pre-formed DSA and kidney allograft outcomes

Yeung, Melissa Y.

doi:10.1590/2175-8239-jbn-2020-0043

Cited by 3 publications

(6 citation statements)

References 8 publications

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“…These results are consistent with the available literature [ 31 , 32 ]. The development of anti-HLA DSAs may be caused before transplantation by pregnancy, blood transfusion, or prior transplantation, or anti-HLA DSAs may develop after transplantation [ 8 ]. In patients with circulating anti-HLA DSAs, 47.4% had anti-HLA DSAs detected before transplantation, and 78.9% had previous transplantation.…”

Section: Discussionmentioning

confidence: 99%

“…Anti-HLA DSAs can be preexisting (preformed) or may develop de novo after transplantation [ 7 ]. Preformed DSAs are caused by exposure to the alloantigens during pregnancy, blood transfusion, or previous transplantation [ 8 , 9 ]. The virtual crossmatch is used to aid in renal allograft allocation and to avoid matching donors to recipients with preformed DSAs [ 10 , 11 ].…”

Section: Introductionmentioning

confidence: 99%

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Association of Circulating Anti-HLA Donor-Specific Antibodies and Their Characteristics, including C1q-Binding Capacity, in Kidney Transplant Recipients with Long-Term Renal Graft Outcomes

Gniewkiewicz

Czerwińska

Zielniok

et al. 2023

JCM

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Post-transplant antihuman leukocyte antigen donor-specific antibodies (anti-HLA DSAs) monitoring in kidney transplant recipients remains unclear and is currently under investigation. The pathogenicity of anti-HLA DSAs is determined by antibody classes, specificity, mean fluorescent intensity (MFI), C1q-binding capacity, and IgG subclasses. The aim of this study was to investigate the association of circulating DSAs and their characteristics with renal allograft long-term outcomes. The study included 108 consecutive patients from our transplant center who underwent kidney allograft biopsy between November 2018 and November 2020, 3 to 24 months after kidney transplantation. At the time of biopsy, patients’ sera were collected for analysis of anti-HLA DSAs. Patients were followed for a median time of 39.0 months (Q1–Q3, 29.8–45.0). Detection of anti-HLA DSAs at the time of biopsy (HR = 5.133, 95% CI 2.150–12.253, p = 0.0002) and their C1q-binding capacity (HR = 14.639, 95% CI 5.320–40.283, p ≤ 0.0001) were independent predictors of the composite of sustained 30% reduction from estimated glomerular filtration rate or death-censored graft failure. Identification of anti-HLA DSAs and their C1q-binding capacity could be useful in identifying kidney transplant recipients at risk for inferior renal allograft function and graft failure. Analysis of C1q is noninvasive, accessible, and should be considered in clinical practice in post-transplant monitoring.

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Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Association of Circulating Anti-HLA Donor-Specific Antibodies and Their Characteristics, including C1q-Binding Capacity, in Kidney Transplant Recipients with Long-Term Renal Graft Outcomes

Gniewkiewicz

Czerwińska

Zielniok

et al. 2023

JCM

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“…where E(x, y) and E s (x, y) are the spatial proximity factor and the brightness similarity factor, respectively, and σ 2 1 and σ 2 K represent the Gaussian kernel variance that controls the similarity factor. Histogram equalization maps the gray level of pixels, stretches the gray value of the entire image range to an average shadow, and improves the contrast and saturation of the image.…”

Section: Medical Image Denoisingmentioning

confidence: 99%

“…Statistics reveal that the incidence of CKD in China is as high as 10.8%, and CKD is often diagnosed in the late stage of kidney disease. Hemodialysis (HD) is the main treatment method for CKD patients [2]. Blood vessels are considered to be the lifeline of HD patients, and the dialysis rate of longterm dialysis patients for HD within 1 year is 60%, and the medical cost is 2 to 3 times that of the ordinary patients [3].…”

Section: Introductionmentioning

confidence: 99%

Care of Maintenance Hemodialysis Patients through Intelligent Algorithm-Based Low-Dose Digital Subtraction Angiography

Hong

2021

Scientific Programming

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Objective. The study aimed to explore the application value of artificial intelligence (AI)-based low-dose digital subtraction angiography (DSA) in the care of maintenance hemodialysis (MHD) patients. Methods. The characteristics of DSA imaging were analyzed, and the refinement efficiency of the AI algorithm was discussed, expected to assist clinicians in the care and treatment of patients. 100 MHD patients who were in the hospital were selected as the research subjects. They were randomly divided into the conventional DSA group (conventional group) and the AI algorithm-based DSA group (AI-based DSA group). The conventional group used conventional DSA images to guide the care of HM patients, and the AI-based DSA group used the AI algorithm to optimize DSA images. Results. It was found that the AI-based DSA group was better than the conventional DSA group in terms of image sharpness and shaded areas, and the image mean square error (MSE) loss value was smaller ( P < 0.05 ). The patients were followed up for 3 months. In the AI-based DAS group, the blood flow of the drainage vein (DV), the blood flow of the proximal vein (PA), and the blood flow of the brachial artery (BA) were greater than those of the conventional group ( P < 0.05 ). During the 3-month follow-up period, in the conventional group, thrombosis occurred in 4 patients, low-flow AVF occurred in 5 patients, high-flow AVF occurred in 3 patients, and heart failure occurred in 5 patients. In the AI-based DSA group, thrombosis occurred in 2 patients, low-flow AVF occurred in 2 cases, high-flow AVF occurred in 1 case, and heart failure occurred in 3 cases. There were no other cardiac complications in both groups. Conclusion. DSA images optimized by the AI algorithm are suitable for clinical diagnosis and have practical application value.

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“…Preformed DSAs can increase the risk of hyperacute rejection, a rapid and severe rejection reaction occurring within minutes to hours after transplantation. 4 To evaluate the presence of DSAs, flow cytometry crossmatch (FCXM) plays a vital role in kidney transplantation, significantly influencing transplant success. 5 This technique measures the binding of DSAs in the recipient's blood to the donor's lymphocytes.…”

mentioning

confidence: 99%

Evaluation of rapid optimized flow cytometry crossmatch (Halifaster) in living donor kidney transplantation

Ramalhete,

Araújo,

Teixeira

et al. 2024

HLA

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Kidney transplantation is often the preferred treatment for end‐stage renal disease. However, the presence of preformed donor‐specific antibodies (DSA), including those against HLA, can lead to antibody‐mediated rejection and significantly impact transplant outcomes. The Flow Cytometry Crossmatch (FCXM) is a crucial tool in kidney transplantation, as it also enables the measurement of low levels of anti‐HLA DSA antibodies. However, current methodologies for detecting these antibodies, however, are time‐consuming and require extensive reagents. In this study, we analyzed the performance of the Halifaster FCXM protocol in 133 consecutive living kidney donor pairs, correlating these results with single antigen‐based anti‐HLA DSA results. Anti‐HLA DSA was identified in 31 patients (23.3%). Both T and B lymphocyte FCXM assays demonstrated high sensitivity and specificity in detecting anti‐HLA DSA. Furthermore, a Tree model to determine the levels of anti‐HLA DSA to produce a flow crossmatch positivity, was developed offering an accuracy of 93% and 90% for T and B lymphocytes, respectively. Both approaches point to a thresh old of 1000–2000 MFI for T lymphocytes and 3000 MFI for B lymphocytes. Our findings indicate that the Halifaster protocol facilitates fast and efficient FCXM testing without compromising accuracy, marking a significant advancement in the field of kidney transplantation. The inclusion of HLA‐specific antibody analysis underscores the protocol's comprehensive approach to improving transplant outcomes.

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Pre-formed DSA and kidney allograft outcomes

Cited by 3 publications

References 8 publications

Association of Circulating Anti-HLA Donor-Specific Antibodies and Their Characteristics, including C1q-Binding Capacity, in Kidney Transplant Recipients with Long-Term Renal Graft Outcomes

Association of Circulating Anti-HLA Donor-Specific Antibodies and Their Characteristics, including C1q-Binding Capacity, in Kidney Transplant Recipients with Long-Term Renal Graft Outcomes

Care of Maintenance Hemodialysis Patients through Intelligent Algorithm-Based Low-Dose Digital Subtraction Angiography

Evaluation of rapid optimized flow cytometry crossmatch (Halifaster) in living donor kidney transplantation

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