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Title: 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
Author: Santos, S.
Malheiro, J.
Tafulo, S.
Dias, L.
Carmo, R.
Sampaio, S.
Costa, M.
Campos, A.
Pedroso, S.
Almeida, M.
Martins, L.
Henriques, C.
Cabrita, A.
Keywords: Anti human leukocyte antigen class I
AntiHLA-Cw antibodies
Antibody-mediated rejection
Donor-specific antibodies
Graft survival
Solid-phase immunoassays
Issue Date: 24-Dec-2016
Publisher: Baishideng Publishing Group
Citation: World J Transplant. 2016 Dec 24;6(4):689-696
Abstract: AIM: To analyze the clinical impact of preformed antiHLA-Cw vs antiHLA-A and/or -B donor-specific antibodies (DSA) in kidney transplantation. METHODS: Retrospective study, comparing 12 patients transplanted with DSA exclusively antiHLA-Cw with 23 patients with preformed DSA antiHLA-A and/or B. RESULTS: One year after transplantation there were no differences in 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, eGFR 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.
Peer review: yes
DOI: 10.5500/wjt.v6.i4.689
ISSN: 2220-3230
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Appears in Collections:SNEF - Artigos publicados em revistas indexadas na Medline

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