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Posttransplant allosensitization in low immunological risk kidney and kidney-pancreas graft recipients.

2014Journal article Open access
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dc.contributor.authorMalheiro, J.
dc.contributor.authorTafulo, S.
dc.contributor.authorDias, L.
dc.contributor.authorMartins, La Salete
dc.contributor.authorFonseca, Isabel
dc.contributor.authorAlmeida, M.
dc.contributor.authorPedroso, S.
dc.contributor.authorFreitas, F.
dc.contributor.authorBeirão, I.
dc.contributor.authorCastro-Henriques, A.
dc.contributor.authorCabrita, A.
dc.date.accessioned2015-07-20T10:41:31Z
dc.date.available2015-07-20T10:41:31Z
dc.date.issued2014
dc.description.abstractINTRODUCTION: Posttransplantation allosensitization prevalence and effect on kidney grafts outcomes remain unsettled. METHODS: Between 2007 and 2012, 408 patients received a primary kidney graft (with 68 patients also receiving a pancreas graft) after a negative cytotoxic crossmatch. All patients had a pretransplant negative anti-HLA screening and 0% panel reactive antibodies. We analyzed retrospectively the results of anti-HLA antibodies screening by Luminex assay, performed between 6 and 24 months after transplant, and searched for the risk factors for antibody positivity and its impact on kidney graft outcomes. RESULTS: Anti-HLA antibodies prevalence at 6 months was 17.4%. Previous steroid-insensitive acute rejection was the only risk factor for both anti-HLA classes detected antibodies. Antithymocyte globulin induction was also a risk factor for anti-HLA-I antibodies. Antibody positivity status was associated with reduced graft function at 12 months and graft survival at 5 years (91.5% versus 96.4%, P = 0.03). In multivariable Cox analysis, delayed graft function (HR = 6.1, P < 0.01), HLA mismatches >3 (HR = 10.2, P = 0.03), and antibody positivity for anti-HLA class II (HR = 5.1, P = 0.04) or class I/II (HR = 13.8, P < 0.01) were independent predictors of graft loss. CONCLUSIONS: Allosensitization against HLA class II ± I after transplant was associated with adverse kidney graft outcomes. A screening protocol seems advisable within the first year in low immunological risk patients.por
dc.identifier.citationNCBINCBI Logo Skip to main content Skip to navigation Resources How To About NCBI Accesskeys Sign in to NCBI PubMed US National Library of Medicine National Institutes of Health Search database Search term Create RSSCreate alertAdvanced Help Result Filters Abstract Send to: See 1 citation: Biomed Res Int. 2014;2014:438945por
dc.identifier.doihttp://dx.doi.org/10.1155/2014/438945
dc.identifier.issn2314-6141
dc.identifier.issn2314-6133
dc.identifier.urihttp://hdl.handle.net/10400.16/1822
dc.language.isoengpor
dc.peerreviewedyespor
dc.publisherHindawi Pub. Co.por
dc.relation.publisherversionhttp://dx.doi.org/10.1155/2014/438945por
dc.titlePosttransplant allosensitization in low immunological risk kidney and kidney-pancreas graft recipients.por
dc.typejournal article
dspace.entity.typePublication
oaire.citation.conferencePlaceUnited States of Americapor
oaire.citation.titleBioMed Research Internationalpor
oaire.citation.volume2014por
person.familyNameMartins
person.familyNameFonseca
person.givenNameLa Salete
person.givenNameIsabel
person.identifier1911437
person.identifier415128
person.identifier.ciencia-id7A1B-8631-FC46
person.identifier.ciencia-id6716-A5D1-FB3F
person.identifier.orcid0000-0002-6110-2102
person.identifier.orcid0000-0001-8984-1751
person.identifier.ridK-6339-2013
person.identifier.scopus-author-id56207848700
person.identifier.scopus-author-id55941495000
rcaap.rightsopenAccesspor
rcaap.typearticlepor
relation.isAuthorOfPublication71fef9db-e03d-423a-af46-2909891b037d
relation.isAuthorOfPublication2c7a2607-6376-486e-9ad5-490d0032946c
relation.isAuthorOfPublication.latestForDiscovery71fef9db-e03d-423a-af46-2909891b037d

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