title: Clinical impact of preformed donor-specific denatured class I HLA antibodies after kidney transplantation.
abstract: Class I single-antigen flow beads (SAFB) carry native and denatured human leukocyte antigen (HLA) molecules. Using a cohort of 179 class I HLA-sensitized kidney recipients, we described incidence and clinical relevance of preformed denatured HLA donor-specific antibodies (DSA) using two different assays: an acid-treated SAFB assay (anti-dHLA DSA) and the iBeads assays (SAFB+/iBeads- DSA). Eighty-five class I DSA were found in 67 patients (median mean fluorescence intensity [MFI] of 1729 [range 520-13 882]). Anti-dHLA and SAFB+/iBeads- DSA represented 11% and 18% of class I DSA and were mainly low MFI DSA (500-1000 MFI). Concordance between these two assays was good (90%). None of the patients with only class I anti-dHLA DSA or only SAFB+/iBeads- DSA developed acute clinical antibody-mediated rejection in the first-year post-transplantation, and their five-yr death-censored graft survival was similar to that of patients without DSA. Moreover, all these patients displayed a negative current T-cell flow cytometry cross-match. Therefore, both anti-dHLA DSA and SAFB+/iBeads- DSA appear irrelevant, which could explain the good outcome observed in some patients with preformed class I DSA.
authors: Laboratoire d'Immunologie et Immunogénétique, Hôpital Pellegrin, CHU de Bordeaux, Bordeaux, France; UMR CNRS 5164, Université de Bordeaux, Bordeaux, France.
authors: Jonathan
authors: J
authors: Visentin
authors: Mélanie
authors: M
authors: Marroc
authors: Gwendaline
authors: G
authors: Guidicelli
authors: Thomas
authors: T
authors: Bachelet
authors: Thoa
authors: T
authors: Nong
authors: Jean-François
authors: JF
authors: Moreau
authors: Jar-How
authors: JH
authors: Lee
authors: Pierre
authors: P
authors: Merville
authors: Lionel
authors: L
authors: Couzi
authors: Jean-Luc
authors: JL
authors: Taupin
mesh_terms: D000918:Antibody Specificity; D005260:Female; D005500:Follow-Up Studies; D005919:Glomerular Filtration Rate; D006085:Graft Survival / Q000276:immunology*; D015395:Histocompatibility Antigens Class I / Q000276:immunology*; D006650:Histocompatibility Testing; D006801:Humans; D007518:Isoantibodies / Q000097:blood / Q000276:immunology*; D007676:Kidney Failure, Chronic / Q000276:immunology* / Q000601:surgery; D007677:Kidney Function Tests; D016030:Kidney Transplantation; D008297:Male; D008875:Middle Aged; D011379:Prognosis; D011489:Protein Denaturation; D012189:Retrospective Studies; D012307:Risk Factors; D014019:Tissue Donors
chemical_list: D015395:Histocompatibility Antigens Class I; D007518:Isoantibodies
keywords: antibody-mediated rejection; denatured class I HLA Antibodies; donor-specific antibodies; human leukocyte antigen; kidney transplantation