title: Posttransplant major histocompatibility complex class I chain-related gene A antibodies and long-term graft outcomes in a multicenter cohort of 779 kidney transplant recipients.
abstract: BACKGROUND
  The impact of major histocompatibility class I chain-related A (MICA) antibodies on renal graft outcomes is unclear. The goal of this work was to assess the impact of posttransplant MICA antibodies, assayed at 1 year, with two commercially available kits, on long-term renal graft outcomes.
  
  
  METHODS
  We retrospectively tested sera from 779 kidney transplant recipients with two single-antigen flow bead assays 1 year after transplantation. Samples were considered positive for MICA if they were positive in both tests or positive for MICA specificities that were present in one kit only. The main outcome was 4-year death-censored graft survival.
  
  
  RESULTS
  The prevalence of MICA antibodies was 5.4% at 1 year. MICA+ patients were more frequently human leukocyte antigen (HLA) sensitized and regrafted. Four-year death-censored graft survival was not different between MICA+ and MICA- patients (97% vs. 94%, P=0.28). By Cox multivariate analysis, independent risk factors for graft loss were as follows: number of HLA DR mismatches, acute rejection within the first year posttransplantation, 1-year serum creatinine, and the presence of HLA antibodies at 1 year, but not the presence of MICA antibodies.
  
  
  CONCLUSIONS
  These data do not support an independent pathogenic role for MICA in long-term renal graft injury and question the interest of posttransplant monitoring of MICA antibodies with single-antigen flow bead assays currently available.
authors.affiliation: Renal Transplantation Clinic, Erasme Hospital, Brussels, Belgium. Anne.Lemy@erasme.ulb.ac.be
authors.forename: Anne
authors.initials: A
authors.lastname: Lemy
authors.forename: Marc
authors.initials: M
authors.lastname: Andrien
authors.forename: Arnaud
authors.initials: A
authors.lastname: Lionet
authors.forename: Myriam
authors.initials: M
authors.lastname: Labalette
authors.forename: Christian
authors.initials: C
authors.lastname: Noel
authors.forename: Christian
authors.initials: C
authors.lastname: Hiesse
authors.forename: Michel
authors.initials: M
authors.lastname: Delahousse
authors.forename: Caroline
authors.initials: C
authors.lastname: Suberbielle-Boissel
authors.forename: Martine
authors.initials: M
authors.lastname: De Meyer
authors.forename: Dominique
authors.initials: D
authors.lastname: Latinne
authors.forename: Michel
authors.initials: M
authors.lastname: Mourad
authors.forename: Séverine
authors.initials: S
authors.lastname: Delsaut
authors.forename: Judith
authors.initials: J
authors.lastname: Racapé
authors.forename: Karl M
authors.initials: KM
authors.lastname: Wissing
authors.forename: Michel
authors.initials: M
authors.lastname: Toungouz
authors.forename: Daniel
authors.initials: D
authors.lastname: Abramowicz
mesh_terms: D000328:Adult; D000368:Aged; D015331:Cohort Studies; D003404:Creatinine / Q000097:blood; D005260:Female; D006084:Graft Rejection / Q000276:immunology* / Q000401:mortality*; D006085:Graft Survival / Q000276:immunology*; D015234:HLA-A Antigens / Q000276:immunology*; D006684:HLA-DR Antigens / Q000276:immunology; D006801:Humans; D007518:Isoantibodies / Q000276:immunology; D016030:Kidney Transplantation / Q000276:immunology* / Q000401:mortality*; D008297:Male; D008875:Middle Aged; D016016:Proportional Hazards Models; D012189:Retrospective Studies; D016036:Seroepidemiologic Studies
chemical_list: D015234:HLA-A Antigens; D006684:HLA-DR Antigens; D007518:Isoantibodies; D003404:Creatinine