The clinical significance of human leukocyte antigen antibody development in kidney transplantation.
BACKGROUND
This retrospective study uses the LAT-M (One Lambda Inc., Calif) screen assay to reexamine the impacts (a), of pretransplant human leukocyte antigen (HLA) antibody on long-term graft survival; (b) posttransplant HLA antibody on long-term graft survival and (c) immunosuppressive regimen on posttransplant HLA antibody development.


METHODS
Pretransplant sera from 222 renal transplant recipients and posttransplant sera from 216 renal transplant recipients were studied for the impact of HLA antibody on long-term graft survival.


RESULTS
Among the patients who did not display pretransplant HLA antibodies, 85% enjoyed 5-year and 59% 10-year graft survival, whereas the patients who tested positive were 83% and 83% (P = .5596). Among the patients who did not show posttransplant HLA antibodies, 99% enjoyed 5-, 91% 10-, and 65% 15-year graft survival, whereas for the 44 patients who tested positive they were 59%, 44%, and 30%, respectively (P < .0001). Patients prescribed cyclosporine + myfortic (odds ratio 0.17, P = .05) or FK + Cellcept (odds ratio 0.36, P = .04) showed the lowest posttransplant HLA antibody development.


CONCLUSIONS
Both regimens improve graft survival.
Department of Surgery, National Chang-Kung University Medical College and Hospital, 138, Sheng-Li Road Tainan 70144, Taiwan. pochang@mail.ncku.edu.tw
P-C
PC
Lee
Y-L
YL
Chen
T-C
TC
Chou
W-M
WM
Wang
J-D
JD
Wang
C-J
CJ
Hung
S-S
SS
Chang
Y-J
YJ
Lin
R-H
RH
Chan
D004797:Enzyme-Linked Immunosorbent Assay; D006084:Graft Rejection / Q000276:immunology / Q000517:prevention & control; D006085:Graft Survival / Q000187:drug effects; D006680:HLA Antigens / Q000276:immunology*; D006648:Histocompatibility; D006801:Humans; D007166:Immunosuppressive Agents / Q000627:therapeutic use; D007518:Isoantibodies / Q000097:blood*; D016030:Kidney Transplantation / Q000276:immunology*; D016017:Odds Ratio; D012189:Retrospective Studies; D018570:Risk Assessment; D012307:Risk Factors; D013624:Taiwan; D013997:Time Factors; D016896:Treatment Outcome
D006680:HLA Antigens; D007166:Immunosuppressive Agents; D007518:Isoantibodies