Differential effects of donor-specific HLA antibodies in living versus deceased donor transplant

American Journal of Transplantation : Official Journal of the American Society of Transplantation and the American Society of Transplant Surgeons
E G KamburovaH G Otten

Abstract

The presence of donor-specific anti-HLA antibodies (DSAs) is associated with increased risk of graft failure after kidney transplant. We hypothesized that DSAs against HLA class I, class II, or both classes indicate a different risk for graft loss between deceased and living donor transplant. In this study, we investigated the impact of pretransplant DSAs, by using single antigen bead assays, on long-term graft survival in 3237 deceased and 1487 living donor kidney transplants with a negative complement-dependent crossmatch. In living donor transplants, we found a limited effect on graft survival of DSAs against class I or II antigens after transplant. Class I and II DSAs combined resulted in decreased 10-year graft survival (84% to 75%). In contrast, after deceased donor transplant, patients with class I or class II DSAs had a 10-year graft survival of 59% and 60%, respectively, both significantly lower than the survival for patients without DSAs (76%). The combination of class I and II DSAs resulted in a 10-year survival of 54% in deceased donor transplants. In conclusion, class I and II DSAs are a clear risk factor for graft loss in deceased donor transplants, while in living donor transplants, class I and II DSAs seem to be...Continue Reading

References

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Citations

Jul 14, 2018·Expert Review of Clinical Immunology·Sebastiaan Heidt, Frans H J Claas
Aug 10, 2018·Transplant International : Official Journal of the European Society for Organ Transplantation·Gonca E KarahanSebastiaan Heidt
Jul 28, 2018·Journal of the American Society of Nephrology : JASN·Elena G KamburovaHenny G Otten
Jun 14, 2019·American Journal of Transplantation : Official Journal of the American Society of Transplantation and the American Society of Transplant Surgeons·Elena G KamburovaHenny G Otten
Jun 4, 2019·American Journal of Transplantation : Official Journal of the American Society of Transplantation and the American Society of Transplant Surgeons·Sebastiaan HeidtFrans H J Claas
Oct 28, 2019·Journal of the American Society of Nephrology : JASN·Matteo TogninalliJakob Nilsson
Nov 21, 2018·International Reviews of Immunology·Pernille Koefoed-Nielsen, Bjarne Kuno Møller
Jun 20, 2019·Clinical Journal of the American Society of Nephrology : CJASN·Malte ZiemannNils Lachmann
Jun 6, 2018·Frontiers in Immunology·Laura A MichielsenHenny G Otten
Oct 27, 2018·Nephrology, Dialysis, Transplantation : Official Publication of the European Dialysis and Transplant Association - European Renal Association·Laura A MichielsenArjan D van Zuilen
Nov 24, 2020·HLA : Immune Response Genetics·Helena CarSebastiaan Heidt
Aug 15, 2018·Transplantation·Bram W WisseHenny G Otten
Mar 16, 2021·American Journal of Physiology. Renal Physiology·Rosa G M LammertsStefan P Berger
Jul 9, 2021·Kidney Research and Clinical Practice·Yohan ParkChul Woo Yang
Sep 26, 2021·Transplant International : Official Journal of the European Society for Organ Transplantation·Caroline WehmeierUNKNOWN Swiss Transplant Cohort Study

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Methods Mentioned

BETA
flow cytometry
Transplant
biopsy
biopsies

Software Mentioned

R
SAS

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