Pre-existing donor-specific antibodies are detrimental to kidney allograft only when persistent after transplantation

Caillard, Sophie; Becmeur, C.; Gautier-Vargas, Gabriela; Olagne, Jérôme; Müller, C.; Cognard, Noëlle; Perrin, Peggy; Braun, Laura; Heibel, Françoise; Lefebre, Francois; Renner, Veronique; Gachet, Christian; Moulin, Anne‐Marie; Parissiadis, A.

doi:10.1111/tri.12864

Cited by 29 publications

(34 citation statements)

References 26 publications

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“…In addition, they showed worse death-censored graft survival than those without DSA at transplantation [3,4,21,22]. Interestingly and opposite to other studies [23][24][25], we found that preformed DSA correlated with postransplant ABMR even if cleared after transplantation, although this latter group exhibited and intermediate risk.…”

Section: Discussioncontrasting

confidence: 98%

Impact of persistent and cleared preformed HLA DSA on kidney transplant outcomes

et al. 2018

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Preformed HLA donor-specific antibodies (DSA) only detected with Luminex have been associated with increased risk of antibody-mediated rejection (ABMR) and graft failure after kidney transplantation (KT). Their evolution after KT may modify this risk. We analyzed postransplant evolution of preformed DSA identified retrospectively and their impact on outcomes of 370 KT performed 2006-2014. Antibodies were monitored prospectively at 1-3-5 years after KT and if any dysfunction. Early acute ABMR was more frequent among patients with preformed DSA class-I or I + II than isolated class-II (29.4% vs 4.5%, p = 0.02). One year post-KT, 20 of 34 patients with functioning KT had persistent DSA. Preformed DSA class-II persisted more frequently than class-I/I + II (66.7% vs 33.3%; p = 0.031). The only risk factor independently associated with persistence was pretransplant MFI. Patients with de novo DSA had the highest risk of ABMR (HR 22.2 [CI 6.1-81.2]). Although recipients with persisting preformed DSA had significantly increased ABMR risk (HR 14.7 [CI 6.5-33.0]), those with cleared preformed DSA also had a higher risk than those without DSA (HR 7.01 [CI 2.2-21.8]). Preformed DSA are a very important risk factor for ABMR and graft loss. Patients who clear preformed DSA still show an increased risk of ABMR and graft loss after KT.

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Section: Discussioncontrasting

confidence: 98%

Impact of persistent and cleared preformed HLA DSA on kidney transplant outcomes

et al. 2018

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“…Likewise, the presence of DSA at 1‐year was similar between patients with DSA (with or without AT1R‐abs) and much higher than in the remaining patients. Recently, it has been shown that preformed DSA were deleterious to graft survival only when they persisted after transplantation . Notwithstanding, in our cohort, presence of DSA at 1‐year was not an independent predictor of graft failure.…”

Section: Discussioncontrasting

confidence: 65%

“…Recently, it has been shown that preformed DSA were deleterious to graft survival only when they persisted after transplantation. 36 Notwithstanding, in our cohort, presence of DSA at 1-year was not an independent predictor of graft failure.…”

Section: Discussioncontrasting

confidence: 51%

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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“…We do not use any specialized immunosuppression protocol for the preformed DSA Recently, there was a report on kidney transplantation that showed preformed DSAs are deleterious to graft survival only when they persist after transplantation. 20 In this prior study, DSA persistence was associated with a higher risk of graft loss and AMR. In the present study, only 2 patients (13.3%) in DSA (+) group showed persistent DSAs after LT in the follow-up period at the time of the biopsy, and this may be due to the fact that there was no significant association between preformed DSA and the outcome of LT in the Cell-based assays are used for lymphocyte cross-matching and have been the gold standard method for decades.…”

Section: Results Of Lymphocyte Cross-matchingmentioning

confidence: 75%

“…Recently, there was a report on kidney transplantation that showed preformed DSAs are deleterious to graft survival only when they persist after transplantation . In this prior study, DSA persistence was associated with a higher risk of graft loss and AMR.…”

Section: Discussionmentioning

confidence: 99%

Preformed donor‐specific antibodies do not affect the 1‐year allograft survival in living donor liver transplantation

Kim

Song

Lee

et al. 2018

Clinical Transplantation

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The effect of preformed donor-specific antibodies (DSAs) on liver transplantation (LT) remains unclear, especially in the field of living donor LT (LDLT). Herein, we evaluated the prevalence of preformed DSAs and their effect on graft outcome in LDLT in the first year following surgery. Using the Luminex Single Antigen assay, we analyzed the preoperative sera of 61 adult LDLT recipients between 2014 and 2015. Clinical outcomes and pathologic findings including complement component 4d (C4d) expression in the first year after LT were retrospectively reviewed. Regardless of the class of DSA, DSAs with mean fluorescence intensity (MFI) ≥1000 were defined as positive and preformed DSA with MFI ≥5000 was defined as strongly positive. Fifteen patients (24.6%) had preformed DSAs, and 8 patients (13.1%) showed strongly positive preformed DSAs. Among 15 DSA positive patients, 2 (13.3%) showed persistent DSAs after LDLT. No de novo DSAs were noted in patients without preformed DSAs. Preformed DSAs were not related to graft dysfunction, laboratory values, or C4d expression or other pathologic findings in the first year of LDLT. In conclusion, preformed DSAs persisted during follow-up in 13.3% of cases and did not have adverse effect on histologic or clinical outcomes in the first year of LDLT.

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Pre-existing donor-specific antibodies are detrimental to kidney allograft only when persistent after transplantation

Cited by 29 publications

References 26 publications

Impact of persistent and cleared preformed HLA DSA on kidney transplant outcomes

Impact of persistent and cleared preformed HLA DSA on kidney transplant outcomes

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

Preformed donor‐specific antibodies do not affect the 1‐year allograft survival in living donor liver transplantation

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