Posttransplant donor-specific antibody characterization and kidney graft survival.
This study was designed to investigate the clinical relevance of donor-specific antibodies (DS-Abs) and their influence on graft survival. Among 106 patients who underwent cadaveric kidney donor transplantation and were monitored by flow cytometry crossmatch (FCXM) during the 1st posttransplantation year, 25 (23.6%) resulted positive for DS-Ab production. During a 2-year follow up only 12 of the 81 FCXM-negative patients (14.8%) suffered rejection vs 17 of 25 FCXM-positive patients (68%; P = 0.00001). Correlating graft loss to DS-Ab production, 9 FCXM-positive patients lost the graft vs only 1 among the FCXM-negative patients. A worse graft function was evidenced in FCXM-positive subjects who had also suffered rejection episodes than in those which had acute rejection but did not produce DS-Abs. A high incidence of HLA-AB mismatches was found in FCXM-positive subjects which produced anti-class I antibodies. FCXM appears useful in estimating posttransplant alloimmune response. Moreover our findings confirm the harmful effects of anti-class I DS-Abs on long-term graft survival.
Piazza
A
A
CNR Tissue Typing Institute, Unit of Rome, Italy.
Borrelli
L
L
Monaco
P I
PI
Poggi
E
E
Pisani
F
F
Valeri
M
M
Fraboni
D
D
Servetti
S
S
Casciani
C U
CU
Adorno
D
D
D000917:Antibody Formation; D002102:Cadaver; D003404:Creatinine / Q000097:blood; D005434:Flow Cytometry; D005500:Follow-Up Studies; D006085:Graft Survival / Q000276:immunology*; D006650:Histocompatibility Testing; D006801:Humans; D007074:Immunoglobulin G / Q000097:blood; D007518:Isoantibodies / Q000276:immunology*; D016030:Kidney Transplantation / Q000276:immunology* / Q000502:physiology; D008214:Lymphocytes / Q000276:immunology; D012189:Retrospective Studies; D013154:Spleen / Q000276:immunology; D014019:Tissue Donors
D007074:Immunoglobulin G; D007518:Isoantibodies; D003404:Creatinine