title: Impact of de novo donor-specific HLA antibodies detected by Luminex solid-phase assay after transplantation in a group of 88 consecutive living-donor renal transplantations.
abstract: De novo donor-specific HLA antibodies (DSA) after renal transplantation are known to be correlated with poor graft outcome and the development of acute and chronic rejection. Currently, data for the influence of de novo DSA in patient cohorts including only living-donor renal transplantations (LDRT) are limited. A consecutive cohort of 88 LDRT was tested for the occurrence of de novo DSA by utilizing the highly sensitive Luminex solid-phase assay for antibody detection. Data were analyzed for risk factors for de novo DSA development and correlated with acute rejection (AR) and graft function. Patients with de novo DSA [31 (35%)] showed a trend for inferior graft function [mean creatinine change (mg/dL/year) after the first year: 0.15 DSA (+) vs. 0.02 DSA (-) (P = 0.10)] and a higher rate of AR episodes, especially in case of de novo DSA of both class I and II [6 (55%), (P = 0.05)]. Antibody-mediated rejection (AMR) appeared in five patients and was significantly correlated with de novo DSA (P = 0.05). Monitoring for de novo DSA after LDRT may help to identify patients at risk of declining renal function. Especially patients with simultaneous presence of de novo DSA class I and class II are at a high risk to suffer AR episodes.
authors.affiliation: Department of General, Visceral and Cancer Surgery, Transplant Center Cologne, University of Cologne, Cologne, Germany.
authors.forename: Georg
authors.initials: G
authors.lastname: Dieplinger
authors.forename: Vanessa
authors.initials: V
authors.lastname: Ditt
authors.forename: Wolfgang
authors.initials: W
authors.lastname: Arns
authors.forename: Andrea
authors.initials: A
authors.lastname: Huppertz
authors.forename: Tuelay
authors.initials: T
authors.lastname: Kisner
authors.forename: Martin
authors.initials: M
authors.lastname: Hellmich
authors.forename: Ursula
authors.initials: U
authors.lastname: Bauerfeind
authors.forename: Dirk L
authors.initials: DL
authors.lastname: Stippel
mesh_terms: D000293:Adolescent; D000328:Adult; D002648:Child; D003404:Creatinine / Q000097:blood; D005260:Female; D006084:Graft Rejection / Q000276:immunology*; D015395:Histocompatibility Antigens Class I / Q000276:immunology; D000949:Histocompatibility Antigens Class II / Q000276:immunology; D006801:Humans; D007518:Isoantibodies / Q000276:immunology*; D016030:Kidney Transplantation / Q000009:adverse effects*; D019520:Living Donors; D008297:Male; D008875:Middle Aged; D012307:Risk Factors; D016896:Treatment Outcome
chemical_list: D015395:Histocompatibility Antigens Class I; D000949:Histocompatibility Antigens Class II; D007518:Isoantibodies; D003404:Creatinine
keywords: AMR; Luminex solid-phase assay; antibody-mediated rejection; de novo 
  DSA; donor-specific antibodies; living-donor renal transplantation