Anticardiolipin antibodies and 12-month graft function in kidney transplant recipients: a prognosis cohort survey

Gauthier, Marion; Canouï‐Poitrine, Florence; Guéry, Esther; Desvaux, Dominique; Hüe, Sophie; Canaud, Guillaume; Stehlé, Thomas; Lang, Philippe; Kofman, Tomek; Grimbert, Philippe; Matignon, Marie

doi:10.1093/ndt/gfx353

Cited by 13 publications

(16 citation statements)

References 29 publications

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“…Most of the studies evaluated recipients positive for aPL (9, 10, 12, 13, 16, 17, 19, 22, 24-26, 28, 29) whereas one study specifically evaluated recipients below the 40GPL/MPL cut-off for positivity but still low positive (31); fewer studies evaluated recipients positive for aPL as…”

Section: Expression Of Antiphospholipid Antibody Positivitymentioning

confidence: 99%

“…The diagnosis of allograft thrombosis was consistently biopsy proven (11,14,15,23,(25)(26)(27)(28)(29)(30)(31) and occasionally supported by renal ultrasound or radionuclide scanning before biopsy (18).…”

Section: Allograft Thrombosismentioning

confidence: 99%

“…Two studies defined/diagnosed acute (humoral and cellular) and delayed allograft rejection by renal biopsy (19,30,31).…”

Section: Allograft Rejectionmentioning

confidence: 99%

“…Nine articles evaluated the relationship between different aPL and allograft thrombosis. They comprised 2106 aPL-ve and 1019 aPL+ve recipients for the effect size of this outcome [11,14,15,23,26,[28][29][30][31]; the pooled prevalence of allograft thrombosis was significantly greater in aPL+ve than negative recipients (10.4% vs 1.7%) with wide heterogeneity (I 2 = 89.5%, p<0.0001) (Figure 2A). Subgroup analysis after removal of three studies dealing with primary APS [10,13,30] still yielded a significant result (p<0.0001) with decreased heterogeneity (I 2 =71%, p<0.004, graph not shown).…”

Section: Allograft Thrombosismentioning

confidence: 99%

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Antiphospholipid antibodies and renal transplant: A systematic review and meta-analysis

Merashli

Bucci

Gentile

et al. 2019

Seminars in Arthritis and Rheumatism

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Objective. To evaluate the effect of antiphospholipid antibodies (aPL) on renal allograft outcome after kidney transplantation. Methods. A systematic search of EMBASE and PubMed databases from inception to July 2018 was run according to PRISMA guidelines; Peto's odds ratio (OR) for rare events was used for the meta-analysis. Results. Our inclusion/exclusion criteria were met by 22 cohort studies having different outcomes: allograft thrombosis (n=9) and thromboprophylaxis (n=3), allograft loss from any cause (n=9), allograft malfunction (n=3), duration (n=2), glomerular filtration rate at 1 year (n=3) and allograft rejection (n=5). The pooled prevalence of allograft thrombosis and of thrombotic microangiopathy was greater in aPL+ve than negative recipients (10.4% vs 1.7%,

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Section: Expression Of Antiphospholipid Antibody Positivitymentioning

confidence: 99%

Section: Allograft Thrombosismentioning

confidence: 99%

“…Two studies defined/diagnosed acute (humoral and cellular) and delayed allograft rejection by renal biopsy (19,30,31).…”

Section: Allograft Rejectionmentioning

confidence: 99%

Section: Allograft Thrombosismentioning

confidence: 99%

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Antiphospholipid antibodies and renal transplant: A systematic review and meta-analysis

Merashli

Bucci

Gentile

et al. 2019

Seminars in Arthritis and Rheumatism

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“…However, other studies could not confirm an association between aPL and allograft survival after kidney transplantation ( 19 ). A very recent study of 446 kidney transplant recipients showed that the risk of GFR decline within the first year post-transplant was elevated in patients with positive aPL, even without thrombotic events prior to transplantation ( 20 ).…”

Section: Kidney Transplantation and Aplmentioning

confidence: 99%

Antiphospholipid Syndrome Nephropathy: From Pathogenesis to Treatment

Tektonidou

2018

Front. Immunol.

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Kidney damage is a well-recognized complication of the antiphospholipid syndrome (APS), either primary or systemic lupus erythematosus (SLE)-associated APS. Kidney involvement in APS involves a variety of manifestations, such as renal artery thrombosis or stenosis, renal vein thrombosis, allograft loss due to thrombosis after kidney transplantation, and injury to the renal microvasculature, also known as APS nephropathy. Biopsy in patients with APS nephropathy includes acute thrombotic microangiopathy lesions and chronic intrarenal vascular lesions such as interlobular fibrous intimal hyperplasia, arterial and arteriolar recanalizing thrombosis, fibrous arterial occlusion, and focal cortical atrophy. The most frequent clinical features are hypertension, microscopic hematuria, proteinuria (ranging from mild to nephritic levels), and renal insufficiency. It is uncertain whether antiphospholipid antibodies or other factors are implicated in the development of APS nephropathy, and whether it is driven mainly by thrombotic or by inflammatory processes. Experimental models and clinical studies of thrombotic microangiopathy lesions implicate activation of the complement cascade, tissue factor, and the mTORC pathway. Currently, the management of APS nephropathy relies on expert opinion, and consensus is lacking. There is limited evidence about the effect of anticoagulants, and their use remains controversial. Treatment approaches in patients with APS nephropathy lesions may include the use of heparin based on its role on complement activation pathway inhibition or the use of intravenous immunoglobulin and/or plasma exchange. Targeted therapies may also be considered based on potential APS nephropathy pathogenetic mechanisms such as B-cell directed therapies, complement inhibition, tissue factor inhibition, mTOR pathway inhibition, or anti-interferon antibodies, but prospective multicenter studies are needed to address their role.

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Autoantibodies and Kidney Diseases

Topaloğlu

Levart

Nagata

et al. 2022

Pediatric Nephrology

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Anticardiolipin antibodies and 12-month graft function in kidney transplant recipients: a prognosis cohort survey

Abstract: ACL without APS before kidney transplantation is an independent risk factor of eGFR decline within the first year post-transplant without over-incidence of TEs. Specific immunosuppressive therapy including mammalian target of rapamycin inhibitors should be discussed in the future.

Cited by 13 publications

References 29 publications

Antiphospholipid antibodies and renal transplant: A systematic review and meta-analysis

Antiphospholipid antibodies and renal transplant: A systematic review and meta-analysis

Antiphospholipid Syndrome Nephropathy: From Pathogenesis to Treatment

Autoantibodies and Kidney Diseases

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