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Impact of preformed donor-specific antibodies against HLA class Ⅰ on kidney graft outcomes:Comparative analysis of exclusively anti-Cw vs anti-A and/or-B antibodies

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World Journal of Transplantation 2016年第4期6卷 689-696页

作者： Sofia Santos Jorge Malheiro sandra tafulo Leonídio Dias Rute Carmo Susana Sampaio Marta Costa Andreia Campos Sofia Pedroso Manuela Almeida La Salete Martins Castro Henriques António Cabrita Department of Nephrology and Kidney Transplantation Centro Hospitalar do Porto Centro do Sangue e Transplanta??o do Porto Department of Nephrology Hospital Sao? Joao?

AIM To analyze the clinical impact of preformed antiH LA-Cw vs antiH LA-A and/or-B donor-specific antibodies(DSA) in kidney *** Retrospective study, comparing 12 patients transplanted with DSA exclusively antiH LA-Cw with 23 patients with preformed DSA antiH LA-A and/or *** One year after transplantation there were no differencesin terms of acute rejection between the two groups(3 and 6 cases, respectively in the DSA-Cw and the DSA-A-B groups; P = 1). At one year, eG FR was not significantly different between groups(median 59 mL /min in DSA-Cw group, compared to median 51 mL /min in DSA-A-B group, P = 0.192). Moreover, kidney graft survival was similar between groups at 5-years(100% in DSA-Cw group vs 91% in DSA-A-B group, P = 0.528). The sole independent predictor of antibody mediated rejection(AMR) incidence was DSA strength(HR = 1.07 per 1000 increase in MFI, P = 0.034). AMR was associated with shortened graft survival at 5-years, with 75% and 100% grafts surviving in patients with or without AMR, respectively(Log-rank P = 0.005).CONCLUSION Our data indicate that DSA-Cw are associated with an identical risk of AMR and impact on graft function in comparison with "classical" class I DSA.

关键词： Donor-specific antibodies Antibody-mediated rejection Anti human leukocyte antigen classⅠ AntiHLACw antibodies Graft survival Solid-phase immunoassays

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