title: Donor-specific HLA antibodies and graft function in kidney-transplanted children - the Vienna cohort.
abstract: In the pediatric population, little is known on de novo DSA development, its impact on graft function, and association with suboptimal IS. We assessed the prevalence of de novo DSA in the Vienna cohort of 40 renal transplanted children and adolescents and prospectively followed its association with clinical parameters, graft function, and proteinuria for one yr. At the cross-sectional analysis (median post-transplant time of five yr), 17% of the patients had developed de novo DSA. All HLA-Ab were anti-HLA class II antibodies and persisted in 85% of the cases until the follow-up screening performed within one yr. Basic clinical and laboratory parameters did not differ between DSA-negative and DSA-positive patients at the time of HLA-Ab screening. Suboptimal IS due to reduced medication or non-adherence could not be proven in DSA-positive patients. The changes in eGFR did not differ during the prospective study period, but there was a significantly higher proteinuria in the DSA-positive patients during the follow-up. Our data demonstrate an overall prevalence of 17% of de novo DSA in a pediatric renal transplant cohort. During 12 months of prospective follow-up time, we could demonstrate a significant impact of de novo DSA presence on proteinuria.
authors.affiliation: Department of Paediatrics and Adolescent Medicine, Medical University Vienna, Austria, Vienna, Austria.
authors.forename: Krisztina
authors.initials: K
authors.lastname: Rusai
authors.affiliation: Department of Paediatrics and Adolescent Medicine, Medical University Vienna, Austria, Vienna, Austria.
authors.forename: Johanna
authors.initials: J
authors.lastname: Dworak
authors.affiliation: Department of Paediatrics and Adolescent Medicine, Medical University Vienna, Austria, Vienna, Austria.
authors.forename: Alexandra
authors.initials: A
authors.lastname: Potemkina
authors.affiliation: University Clinic for Blood Group Serology and Transfusion Medicine, Medical University Vienna, Austria, Vienna, Austria.
authors.forename: Gottfried
authors.initials: G
authors.lastname: Fischer
authors.affiliation: Department of Paediatrics and Adolescent Medicine, Medical University Vienna, Austria, Vienna, Austria.
authors.forename: Dagmar
authors.initials: D
authors.lastname: Csaicsich
authors.affiliation: Department of Paediatrics and Adolescent Medicine, Medical University Vienna, Austria, Vienna, Austria.
authors.forename: Klaus
authors.initials: K
authors.lastname: Arbeiter
authors.affiliation: Department of Paediatrics and Adolescent Medicine, Medical University Vienna, Austria, Vienna, Austria.
authors.forename: Christoph
authors.initials: C
authors.lastname: Aufricht
authors.affiliation: Department of Paediatrics and Adolescent Medicine, Medical University Vienna, Austria, Vienna, Austria.
authors.forename: Thomas
authors.initials: T
authors.lastname: Müller-Sacherer
mesh_terms: D000293:Adolescent; D015415:Biomarkers / Q000097:blood; D002648:Child; D002675:Child, Preschool; D003430:Cross-Sectional Studies; D005260:Female; D005919:Glomerular Filtration Rate; D006680:HLA Antigens / Q000276:immunology*; D006801:Humans; D007518:Isoantibodies / Q000097:blood / Q000276:immunology*; D007668:Kidney / Q000276:immunology / Q000503:physiopathology*; D016030:Kidney Transplantation; D008297:Male; D011183:Postoperative Complications / Q000097:blood / Q000175:diagnosis / Q000276:immunology*; D011446:Prospective Studies; D011507:Proteinuria / Q000097:blood / Q000175:diagnosis / Q000209:etiology / Q000276:immunology*; D055815:Young Adult
chemical_list: D015415:Biomarkers; D006680:HLA Antigens; D007518:Isoantibodies
keywords: donor-specific HLA antibodies; graft function; proteinuria