Pretransplant serum IgA concentration and IgA-anti-Fab autoantibody activity as prognostic indicators of kidney graft survival.
IgA concentration and IgA-anti-Fab autoantibody activity were tested in pretransplant sera of 308 kidney graft recipients. Recipients with a serum IgA concentration of 2 g/l or greater had a 1-year graft survival rate of 83%, compared with a 68% rate in recipients with serum IgA of less than 2 g/l (P < 0.005). Serum IgA concentration and IgA-anti-Fab autoantibody activity were significantly associated (r = 0.38, P < 0.0001). Recipients with a high pretransplant IgA-anti-Fab activity had a significantly better graft survival rate (81%) than patients with low pretransplant IgA-anti-Fab (67%, P < 0.025). When IgA-anti-Fab and serum IgA were considered together, 137 recipients with high IgA-anti-Fab and high serum IgA had a 86% 1-year graft survival rate, which was significantly better than the 63% survival rate in patients with low IgA-anti-Fab and low serum IgA (P < 0.0005). The pretransplant serum IgA level and IgA-anti-Fab autoantibody activity were excellent predictors of kidney graft outcome.
Department of Transplantation Immunology, Institute of Immunology, University of Heidelberg, Germany.
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C
Süsal
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Dörr
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J
Groth
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May
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G
Opelz
D001323:Autoantibodies / Q000097:blood*; D016009:Chi-Square Distribution; D004797:Enzyme-Linked Immunosorbent Assay; D006085:Graft Survival / Q000276:immunology*; D006801:Humans; D007070:Immunoglobulin A / Q000097:blood* / Q000276:immunology*; D007140:Immunoglobulin Fab Fragments / Q000276:immunology*; D016030:Kidney Transplantation / Q000276:immunology*; D011379:Prognosis; D012044:Regression Analysis; D012189:Retrospective Studies; D013997:Time Factors
D001323:Autoantibodies; D007070:Immunoglobulin A; D007140:Immunoglobulin Fab Fragments