Analysis of preformed donor-specific anti-HLA antibodies characteristics for prediction of antibody-mediated rejection in kidney transplantation

Malheiro, Jorge; Tafulo, Sandra; Dias, Leonídio; Martins, La Salete; Fonseca, Isabel; Beirão, Idalina; Castro-Henriques, António; Cabrita, António

doi:10.1016/j.trim.2015.01.002

Cited by 53 publications

(48 citation statements)

References 27 publications

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“…Given our limited access to assays for the determination of AT1R‐abs, due to financial constraints, we selected adult patients who received a kidney‐only transplant in our unit in 2009. Previous studies from our centre had shown that a high number of patients transplanted in 2009 had preformed DSA. The flowchart defining study cohort is depicted in Figure , with 76 patients being enrolled.…”

Section: Methodsmentioning

confidence: 92%

“…These developments have allowed the advancement of knowledge about the clinical impact of the presence of donor‐specific antibodies (DSA), detected pre‐ and post‐transplant, on KT outcomes, namely antibody‐mediated rejection (ABMR) and graft loss . Furthermore, in an effort to gain granularity on DSA pathogenicity, several DSA characteristics, as strength, C1q‐binding ability or HLA class, have been correlated with the aforementioned outcomes, improving our ability to stratify risk in patients with DSA . Notwithstanding, some areas of uncertainty about their clinical impact remain …”

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confidence: 99%

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Deleterious effect of anti‐angiotensin II type 1 receptor antibodies detected pretransplant on kidney graft outcomes is both proper and synergistic with donor‐specific anti‐HLA antibodies

Malheiro

Tafulo²,

Dias

et al. 2019

Nephrology

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Section: Methodsmentioning

confidence: 92%

mentioning

confidence: 99%

Deleterious effect of anti‐angiotensin II type 1 receptor antibodies detected pretransplant on kidney graft outcomes is both proper and synergistic with donor‐specific anti‐HLA antibodies

Malheiro

Tafulo²,

Dias

et al. 2019

Nephrology

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“…The negative impact of preformed donor‐specific antibodies (DSAs) in isolated KT is well known, ( 1‐5 ) and the risk of hyperacute kidney rejection is high in the presence of a positive complement‐dependent cytotoxicity crossmatch (CDCXM). ( 6 ) Also, the presence of pretransplant DSAs has been associated with patient mortality.…”

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confidence: 99%

Kidney Graft Outcomes in High Immunological Risk Simultaneous Liver‐Kidney Transplants

et al. 2020

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Recipients of simultaneous liver‐kidney transplantations (SLKTs) have a lower risk of rejection compared with recipients of kidney transplants alone. However, there is disagreement about the impact of pretransplant anti–human leukocyte antigen sensitization on patient and kidney graft survival in the long term. The aim of the study was to evaluate the impact of the recipient immunological risk and comorbidities in renal graft outcomes on SLKT. We reviewed the SLKTs performed in our center from May 1993 until September 2017. Patient and graft survival were analyzed according to the immunological risk, comorbidities, liver and kidney rejection episodes, immunosuppression, and infections. A total of 20 recipients of SLKT were considered in the high immunological risk (HIR) group, and 68 recipients were included in the low immunological risk (LIR) control group. The prevalence of hepatitis C virus infection, second renal transplant, and time on dialysis prior to transplantation were significantly higher in the HIR group. The incidence of acute kidney rejection was higher in the HIR group (P<0.01). However, death‐censored kidney graft survival as well as the estimated glomerular filtration rate at follow‐up were not different between the 2 groups. Comorbidities, but not the immunological risk, impact negatively on patient survival. Despite the higher incidence of rejection in the HIR SLKT group, longterm renal function and graft survival were similar to the LIR group.

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“…As shown in Figure 1 and Table 3, although the positivity of a serum sample for both classes is almost in agreement, when we compared the positivity only regarding 1 of the 2 antibody classes, we observed some differences: the screening kit of vendor A showed more positive cases than the screening kit of vendor B for class I. Conversely, there were more positive cases for class II for vendor B than for vendor A. Anti-HLA antibody screening is crucial for patients awaiting a transplant and during post transplant follow-up. 13 However, there are still some unclear issues, and many reports have discussed limitations of the techniques and other reports state concerns about the significance of these antibodies and their clinical implications in organ transplant. [14][15][16] In addition, each laboratory has adopted its own cut-off to determine the threshold of positivity, with no standardization to date.…”

Section: Discussionmentioning

confidence: 99%

Untitled

Minucci

Resse

Sabia³

et al. 2017

Exp Clin Transplant

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Objectives: For decades, the detection of anti-HLA antibodies in candidates for solid-organ transplant has been performed with the traditional complementdependent cytotoxicity method; this assay has been then integrated with the introduction of solid-phase assays. Over the past 20 years, the Luminex assay has become the most widely used in clinical laboratories due to both increased sensitivity and specificity versus enzyme-linked immunosorbent assay. However, even the Luminex technique has shown some critical issues, and choosing the most reliable method still remains challenging. In this study, we verified the concordance of the results obtained in detecting anti-HLA antibodies with 2 kit vendors that provide reagents for the Luminex platform. Materials and Methods: We used 314 serum samples from patients on wait lists for solid-organ transplant. Sera were tested with LABScreen Mixed-LSM12 (One Lambda-Thermo Fisher, Canoga Park, CA, USA) and LIFECODES LifeScreen Deluxe-LMX (Gen-ProbeImmucor, Stanford, CT, USA),which we indicated as vendor A and vendor B, respectively. Anti-HLA class I and class II antibody analyses were conducted by verifying the concordance of the results with Cohen kappa coefficient statistics and confidence interval. Results:The kappa coefficient statistics showed "substantial" reliability for class I (0.61; confidence interval, 0.50-0.73) and "moderate" reliability for class II (0.56; confidence interval, 0.43-0.69). There were no considerable differences in results between the 2 kits regarding overall assignment of negativity or positivity of a sample. Discordant data between positive values for a test and negative for the other were found for samples with weak antibody positivity. Conclusions: Some discordant data were probably attributable to several factors such as the composition of the kits, the antibody titer in the serum, whether sera were diluted, different washing methods, and type of plate used.

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Analysis of preformed donor-specific anti-HLA antibodies characteristics for prediction of antibody-mediated rejection in kidney transplantation

Cited by 53 publications

References 27 publications

Deleterious effect of anti‐angiotensin II type 1 receptor antibodies detected pretransplant on kidney graft outcomes is both proper and synergistic with donor‐specific anti‐HLA antibodies

Deleterious effect of anti‐angiotensin II type 1 receptor antibodies detected pretransplant on kidney graft outcomes is both proper and synergistic with donor‐specific anti‐HLA antibodies

Kidney Graft Outcomes in High Immunological Risk Simultaneous Liver‐Kidney Transplants

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