title: Pre- and Posttransplant IgA Anti-Fab Antibodies to Predict Long-term Kidney Graft Survival.
abstract: OBJECTIVE
  Immunologic factors are reliable markers for allograft monitoring, because of their seminal role in rejection process. One of these factors is the immunoglobulin (Ig)A anti-Fab of the IgG antibody. This study aimed to evaluate the predictive value of pre- and posttransplant levels of this marker for kidney allograft function and survival.
  
  
  METHODS
  Sera samples of 59 living unrelated donor kidney recipients were collected before and after transplantation (days 7, 14, and 30) and investigated for IgA anti-Fab of IgG antibody levels using enzyme-linked immunosorbent assay in relation with allograft outcome.
  
  
  RESULTS
  Among 59 patients, 15 cases (25%) including 10 with acute rejection and 5 with chronic rejection episodes showed graft failure during a mean of 5 years of follow-up. High posttransplant levels of IgA anti-Fab antibodies were observed more frequently in patients with stable graft function (SGF) compared with patients with graft failure (P = 2 × 10(-6)). None of patients with acute or chronic rejection episodes had high levels of IgA anti-Fab antibodies at day 30 posttransplant compared with the SGF group (P = 10(-6) and P = .01, respectively). In addition, high levels of IgA anti-Fab antibody correlated with lesser concentration of serum creatinine at 1 month posttransplantation (P = .01). Five-year graft survival was associated with high levels of pre- and posttransplant IgA anti-Fab antibodies (P = .02 and P = .003, respectively).
  
  
  CONCLUSIONS
  Our findings indicate the protective effect of higher levels of IgA anti-Fab antibodies regarding to kidney allograft outcomes and long-term graft survival.
authors.affiliation: Department of Urology, Medical School, Hamadan University of Medical Sciences, Hamadan, Iran.
authors.forename: M A
authors.initials: MA
authors.lastname: Amirzargar
authors.affiliation: Molecular Immunology Research Center, Medical School, Tehran University of Medical Sciences, Tehran, Iran.
authors.forename: A
authors.initials: A
authors.lastname: Amirzargar
authors.affiliation: Urology Research Center, Labbafinejad Hospital, Shahid Beheshti University of Medical Sciences, Tehran, Iran.
authors.forename: A
authors.initials: A
authors.lastname: Basiri
authors.affiliation: Immunology Department, Medical School, Hamadan University of Medical Sciences, Hamadan, Iran.
authors.forename: M
authors.initials: M
authors.lastname: Hajilooi
authors.affiliation: Research Center for Health Science, Department of Biostatistics and Epidemiology, School of Health, Hamadan University of Medical Sciences, Hamadan, Iran.
authors.forename: G
authors.initials: G
authors.lastname: Roshanaei
authors.affiliation: Department of Urology, Medical School, Hamadan University of Medical Sciences, Hamadan, Iran.
authors.forename: G
authors.initials: G
authors.lastname: Rajabi
authors.affiliation: Immunology Department, Medical School, Hamadan University of Medical Sciences, Hamadan, Iran; Psoriasis Research Center, Department of Dermatology, Farshchian Hospital, Hamadan University of Medical Sciences, Hamadan, Iran. Electronic address: gh.solgi@umsha.ac.ir.
authors.forename: G
authors.initials: G
authors.lastname: Solgi
mesh_terms: D000328:Adult; D015415:Biomarkers / Q000378:metabolism; D004797:Enzyme-Linked Immunosorbent Assay; D005260:Female; D006084:Graft Rejection / Q000276:immunology*; D006085:Graft Survival / Q000276:immunology*; D006801:Humans; D007070:Immunoglobulin A / Q000276:immunology*; D007140:Immunoglobulin Fab Fragments / Q000276:immunology*; D016030:Kidney Transplantation; D019520:Living Donors; D008297:Male; D057234:Preoperative Period; D012189:Retrospective Studies; D013997:Time Factors; D014184:Transplantation, Homologous
chemical_list: D015415:Biomarkers; D007070:Immunoglobulin A; D007140:Immunoglobulin Fab Fragments