Impact of Preformed Donor-Specific Anti-HLA-Cw and Anti-HLA-DP Antibodies on Acute Antibody-Mediated Rejection in Kidney Transplantation

被引：3

作者：

Laboux, Timothee ^{[1
,2
]}

Lenain, Remi ^{[1
,3
]}

Visentin, Jonathan ^{[4
,5
]}

Flahaut, Gauthier ^{[6
,7
]}

Chamley, Paul ^{[8
]}

Provot, Francois ^{[1
]}

Top, Isabelle ^{[9
]}

Kerleau, Clarisse ^{[10
,11
]}

Labalette, Myriam ^{[9
,12
]}

Choukroun, Gabriel ^{[6
,7
]}

Couzi, Lionel ^{[5
,13
]}

Blancho, Gilles ^{[10
,11
]}

Hazzan, Marc ^{[1
]}

Maanaoui, Mehdi ^{[1
,14
]}

机构：

[1] Univ Lille, Dept Nephrol Kidney Transplantat & Dialysis, CHU Lille, Lille, France

[2] Univ Lille, RID AGE, INSERM, U1167, Lille, France

[3] Nantes Univ, Tours Univ, INSERM UMR 1246 SPHERE, Nantes, France

[4] CHU Bordeaux, Dept Immunol & Immunogenet, Bordeaux, France

[5] Univ Bordeaux, ImmunoConceEpT, CNRS UMR5164, Inserm ERL U1303, Bordeaux, France

[6] Jules Verne Univ Picardie, Dept Nephrol Internal Med Dialysis & Transplantat, CHU Amiens, Amiens, France

[7] Jules Verne Univ Picardie, Lab MP3CV, EA7517, Amiens, France

[8] CH Roubaix, Dept Nephrol, Roubaix, France

[9] Univ Lille, Dept Immunol HLA, CHU Lille, Lille, France

[10] CHU Nantes, Serv Nephrol Immunol Clin, ITUN, Nantes, France

[11] Nantes Univ, Ctr Res Transplantat & Translat Immunol, INSERM, UMR 1064,ITUN, Nantes, France

[12] Univ Lille, INSERM UMR1286, INFINITE, Lille, France

[13] CHU Bordeaux, Dept Nephrol Transplantat Dialysis & Apheresis, Bordeaux, France

[14] Univ Lille, Inst Pasteur Lille, EGID, Inserm U1190,CHU Lille, Lille, France

来源：

TRANSPLANT INTERNATIONAL | 2023年 / 36卷

关键词：

donor-specific antibodies; kidney transplant; acute antibody-mediated rejection; HLA-Cw; HLA-DP; HUMAN-LEUKOCYTE ANTIGEN; SENSITIZED PATIENTS; RECIPIENTS; PLASMAPHERESIS; RITUXIMAB; RISK;

D O I：

10.3389/ti.2023.11416

中图分类号：

R61 [外科手术学];

学科分类号：

摘要：

Given the risk of rejection, the presence of preformed donor specific antibodies (DSA) contraindicates transplantation in most allocation systems. However, HLA-Cw and -DP DSA escape this censorship. We performed a multicentric observational study, in which the objective was to determinate risk factors of acute antibody-mediated rejection (aABMR) in recipients transplanted with preformed isolated Cw- or DP-DSA. Between 2010 and 2019, 183 patients were transplanted with a preformed isolated Cw- or DP-DSA (92 Cw-DSA; 91 DP-DSA). At 2 years, the incidence of aABMR was 12% in the Cw-DSA group, versus 28% in the DP-DSA group. Using multivariable Cox regression model, the presence of a preformed DP-DSA was associated with an increased risk of aABMR (HR = 2.32 [1.21-4.45 (p = 0.001)]) compared with Cw-DSA. We also observed a significant association between the DSA's MFI on the day of transplant and the risk of aABMR (HR = 1.09 [1.08-1.18], p = 0.032), whatever the DSA was. Interaction term analysis found an increased risk of aABMR in the DP-DSA group compared with Cw-DSA, but only for MFI below 3,000. These results may plead for taking these antibodies into account in the allocation algorithms, in the same way as other DSA.

引用

页数：11

共 40 条

[1] Addition of plasmapheresis decreases the incidence of acute antibody-medited rejection in sensitized patients with strong donor-specific antibodies [J].