title: Incidence of donor-specific antibodies in kidney transplant patients following conversion to an everolimus-based calcineurin inhibitor-free regimen.
abstract: Scarce data exist regarding the incidence of donor-specific antibodies (DSAs) in kidney transplant patients receiving everolimus-based immunosuppression without calcineurin inhibitors (CNIs). The aim of this retrospective case-control study was to compare the incidence of de novo DSAs in patients converted to an everolimus-based regimen without CNIs with that seen in patients maintained on CNIs. Sixty-one DSA-free kidney transplant patients who had been converted to an everolimus-based regimen (everolimus group) were compared to 61 other patients maintained on CNIs-based regimen (control group). Patients were matched according to age, gender, induction therapy, date of transplantation, and being DSA-free at baseline. At last follow-up, the incidence of DSAs was 9.8% in the everolimus group and 5% in the control group (p = ns). In the everolimus group, the increased incidence of DSAs between baseline and last follow-up was statistically significant. Antibody-mediated rejection occurred in 6.5% in the everolimus group and 0% in the CNIs group. The incidence of DSAs is numerically increased in kidney transplant patients treated with an everolimus-based without CNIs. A study including a larger number of patients is required to determine whether a CNI-free everolimus-based immunosuppression significantly increases DSAs formation.
authors.affiliation: Department of Nephrology, Dialysis and Organ Transplantation, CHU Rangueil, Toulouse, France. kamar.n@chu-toulouse.fr
authors.forename: Nassim
authors.initials: N
authors.lastname: Kamar
authors.forename: Arnaud
authors.initials: A
authors.lastname: Del Bello
authors.forename: Nicolas
authors.initials: N
authors.lastname: Congy-Jolivet
authors.forename: Céline
authors.initials: C
authors.lastname: Guilbeau-Frugier
authors.forename: Isabelle
authors.initials: I
authors.lastname: Cardeau-Desangles
authors.forename: Marylise
authors.initials: M
authors.lastname: Fort
authors.forename: Laure
authors.initials: L
authors.lastname: Esposito
authors.forename: Joelle
authors.initials: J
authors.lastname: Guitard
authors.forename: Xavier
authors.initials: X
authors.lastname: Gamé
authors.forename: Lionel
authors.initials: L
authors.lastname: Rostaing
mesh_terms: D065095:Calcineurin Inhibitors; D016022:Case-Control Studies; D000068338:Everolimus; D005260:Female; D005500:Follow-Up Studies; D005602:France / Q000453:epidemiology; D006084:Graft Rejection / Q000188:drug therapy / Q000453:epidemiology* / Q000276:immunology; D006085:Graft Survival / Q000276:immunology; D006801:Humans; D007166:Immunosuppressive Agents / Q000627:therapeutic use*; D007518:Isoantibodies / Q000097:blood / Q000276:immunology*; D007674:Kidney Diseases / Q000276:immunology* / Q000601:surgery; D016030:Kidney Transplantation; D008297:Male; D008875:Middle Aged; D011379:Prognosis; D012189:Retrospective Studies; D012307:Risk Factors; D020123:Sirolimus / Q000031:analogs & derivatives* / Q000627:therapeutic use; D014019:Tissue Donors
chemical_list: D065095:Calcineurin Inhibitors; D007166:Immunosuppressive Agents; D007518:Isoantibodies; D000068338:Everolimus; D020123:Sirolimus