Impact of ABO Incompatibility on the Development of Acute Antibody-Mediated Rejection in Kidney Transplant Recipients Presensitized to HLA

被引：14

作者：

Chung, Byung Ha ^{[1
,2
]}

Joo, Yu Young ^{[2
]}

Lee, Jaesin ^{[2
]}

Kim, Hyung Duk ^{[2
]}

Kim, Ji-Il ^{[1
,3
]}

Moon, In Sung ^{[1
,3
]}

Choi, Bum Soon ^{[1
,2
]}

Oh, Eun-Jee ^{[4
]}

Park, Cheol Whee ^{[1
,2
]}

Kim, Yong-Soo ^{[1
,2
]}

Yang, Chul Woo ^{[1
,2
]}

机构：

[1] Catholic Univ Korea, Seoul St Marys Hosp, Coll Med, Transplant Res Ctr, Seoul, South Korea

[2] Catholic Univ Korea, Seoul St Marys Hosp, Coll Med, Dept Internal Med,Div Nephrol, Seoul, South Korea

[3] Catholic Univ Korea, Seoul St Marys Hosp, Coll Med, Dept Surg, Seoul, South Korea

[4] Catholic Univ Korea, Seoul St Marys Hosp, Coll Med, Dept Lab Med, Seoul, South Korea

来源：

PLOS ONE | 2015年 / 10卷 / 04期

基金：

新加坡国家研究基金会;

关键词：

POSITIVE-CROSS-MATCH; SUCCESSFUL RENAL-TRANSPLANTATION; DONOR-SPECIFIC ANTIBODIES; SINGLE ANTIGEN-ASSAY; SENSITIZED PATIENTS; CLASS-I; DESENSITIZATION; RITUXIMAB; TITER; RISK;

D O I：

10.1371/journal.pone.0123638

中图分类号：

O [数理科学和化学]; P [天文学、地球科学]; Q [生物科学]; N [自然科学总论];

学科分类号：

07 ; 0710 ; 09 ;

摘要：

Whether the coexistence of anti-A/B antibody and donor specific anti-HLA antibody (HLA-DSA) has a synergistic impact on the development of acute antibody-mediated rejection (AAMR) in kidney transplant recipients (KTRs) is unclear. This study includes 92 KTRs who received a kidney from an ABO-incompatible (ABOi) donor or were presensitized to donor HLA (HLAs) and 292 controls (CONT). HLAs was defined as a crossmatch positivity or the presence of HLA-DSA. We compared the incidence of AAMR among ABOi (n = 58), ABOi +HLAs (n = 12), HLAs (n = 22), and CONT (n = 292) groups and evaluated the risk factors and antibody type (anti-A/B vs. HLA-DSA) responsible for AAMR. AAMR developed less frequently in ABOi and CONT than in the ABOi+HLAs or HLAs (P < 0.05 for all); however, there was no difference between the ABOi+HLAs and HLAs groups. AAMR developed more frequently with strong HLA-DSA at baseline; however, high baseline anti-A/B titer did not affect AAMR development. Strong baseline HLA-DSA was an independent predictor for AAMR, however the baseline anti-A/B titer was not. All four AAMR episodes in ABOi+HLAs were positive to HLA-DSA but not to anti-A/B. In conclusion, ABO incompatibility does not increase the risk for AAMR in HLAs KTRs.

引用

页数：14

共 35 条

[1] Combined use of rituximab and plasmapheresis pre-transplant increases post-transplant infections in renal transplant recipients with basiliximab induction therapy [J].