title: Donor-Specific Antibodies After Starting Hemodialysis in Nonrenal Solid Organ Transplant Recipients: Role of TH17.
abstract: BACKGROUND
  Nonrenal transplantation could cause a progressive deterioration in renal function until need dialysis. It is important to know if these patients increased their risk to develop de novo donor-specific anti-HLA antibody (DSA) after starting hemodialysis (HD) and if so, try to find the mechanism.
  
  
  METHODS
  In this double-phase study, we first analyzed the incidence of development DSA in nonrenal transplant recipients after starting HD by a retrospective study. Secondly, a prospective study was designed to analyze the pharmacokinetics of immunosuppressive drugs and the cytokine profile of these patients.
  
  
  RESULTS
  Of 179 pancreas transplant recipients, 16 needed to start HD, and 62.5% of these patients developed de novo DSA after starting HD, with 80% of them class I DSA. In the second phase of the study, the plasma levels of the immunosuppressive drugs as measured by a limited sampling strategy of 3 sample time points (C0, C2, and C4) were stable. The cytokine profile showed that there was an increase in Th1 cytokine (interferon gamma of 0.045 ng/mL) and also in Th17 cytokines (transforming growth factor β >10 ng/mL).
  
  
  CONCLUSIONS
  Our data suggest that the development of DSA after starting HD in nonrenal transplant recipients could be mediated by Th17 immune response mechanisms.
authors.affiliation: Servicio de Nefrología, Hospital Universitario Reina Sofía, Córdoba, Spain; Instituto Maimónides de investigación biomédica de Córdoba (IMIBIC), Universidad de Córdoba, Córdoba, Spain; RedInRen, Instituto de salud Carlos III, Spain. Electronic address: marisa.aguera@gmail.com.
authors.forename: M L
authors.initials: ML
authors.lastname: Agüera
authors.affiliation: Servicio de Nefrología, Hospital Universitario Reina Sofía, Córdoba, Spain; Instituto Maimónides de investigación biomédica de Córdoba (IMIBIC), Universidad de Córdoba, Córdoba, Spain; RedInRen, Instituto de salud Carlos III, Spain.
authors.forename: A R
authors.initials: AR
authors.lastname: Hurtarte
authors.affiliation: Servicio de Nefrología, Hospital Universitario Reina Sofía, Córdoba, Spain; Instituto Maimónides de investigación biomédica de Córdoba (IMIBIC), Universidad de Córdoba, Córdoba, Spain; RedInRen, Instituto de salud Carlos III, Spain.
authors.forename: M A
authors.initials: MA
authors.lastname: Álvarez de Lara
authors.affiliation: Servicio de Farmacia, Hospital Universitario Reina Sofía, Córdoba, Spain.
authors.forename: M D
authors.initials: MD
authors.lastname: Aumente
authors.affiliation: Instituto Maimónides de investigación biomédica de Córdoba (IMIBIC), Universidad de Córdoba, Córdoba, Spain; RedInRen, Instituto de salud Carlos III, Spain.
authors.forename: A
authors.initials: A
authors.lastname: Carmona
authors.affiliation: Servicio de Nefrología, Hospital Universitario Reina Sofía, Córdoba, Spain; Instituto Maimónides de investigación biomédica de Córdoba (IMIBIC), Universidad de Córdoba, Córdoba, Spain; RedInRen, Instituto de salud Carlos III, Spain.
authors.forename: J
authors.initials: J
authors.lastname: Carracedo
authors.affiliation: Servicio de Nefrología, Hospital Universitario Reina Sofía, Córdoba, Spain; Instituto Maimónides de investigación biomédica de Córdoba (IMIBIC), Universidad de Córdoba, Córdoba, Spain; RedInRen, Instituto de salud Carlos III, Spain.
authors.forename: P
authors.initials: P
authors.lastname: Aljama
authors.affiliation: Servicio de Nefrología, Hospital Universitario Reina Sofía, Córdoba, Spain; Instituto Maimónides de investigación biomédica de Córdoba (IMIBIC), Universidad de Córdoba, Córdoba, Spain; RedInRen, Instituto de salud Carlos III, Spain.
authors.forename: A
authors.initials: A
authors.lastname: Rodríguez Benot
mesh_terms: D000328:Adult; D000906:Antibodies / Q000276:immunology*; D000961:Antilymphocyte Serum / Q000276:immunology; D005260:Female; D006084:Graft Rejection / Q000276:immunology; D006680:HLA Antigens / Q000276:immunology*; D016027:Heart Transplantation; D006801:Humans; D007108:Immune Tolerance / Q000276:immunology; D015994:Incidence; D020381:Interleukin-17 / Q000502:physiology; D007518:Isoantibodies / Q000276:immunology; D007676:Kidney Failure, Chronic / Q000276:immunology; D016030:Kidney Transplantation; D008297:Male; D008875:Middle Aged; D016035:Pancreas Transplantation; D011446:Prospective Studies; D006435:Renal Dialysis; D012189:Retrospective Studies; D012307:Risk Factors; D058504:Th17 Cells / Q000276:immunology*; D014019:Tissue Donors; D066027:Transplant Recipients
chemical_list: D000906:Antibodies; D000961:Antilymphocyte Serum; D006680:HLA Antigens; D020381:Interleukin-17; D007518:Isoantibodies