Date: Monday, June 13, 2016
Session Time: 6:00pm-7:00pm
Presentation Time: 6:00pm-7:00pm
Location: Halls C&D
HLA specific antibodies detection (HSA) and that of Donor Specific Antibodies (DSA) were revolutionized by the introduction of solid phase assays (Luminex®), therefore making these antibodies a powerful biomarker for humoral injuries to the allograft. Determinants of HSA development entail non-adherence to immunosuppressive drugs but also allosensitizing events such as red blood cell (RBC) transfusions. Recent works showed a higher incidence of DSA in transplanted patients following RBC transfusion events, but no specific data exist for AntiThymocyte Globulin (ATG) induction.
This work aims at assessing whether peri-transplant RBC transfusion resulted in post-transplant HLA sensitization, in the setting of ATG induction therapy.
Patients and methods:
All consecutive patients benefiting from a first ATG-induced kidney allograft between 2004 and 2014 at our center with no history of HLA immunization were included retrospectively, provided transfusion history and HSA history were available. Our endpoint was immunization-free survival. Early transplantation was defined as a RBC transfusion within the first three months after transplantation. We defined de-novo HLA sensitization as at least one positive Luminex test post-transplantation (whether class I or II).
Among the 1018 kidney transplants performed at our center, 332 patients corresponded to our inclusion criteria (89% of our patient received ATG induction). Of these, 120 (36%) received at least on RBC unit within the first three months after transplantation. With a median follow-up of 4.8 years, de-novo HLA sensitization occurred in 90 patients (33%) in the no RBC transfusion group VS 45 patients (66%) in the RBC transfusion group (chi-squared test: p=0.39, log-rank test: p=0.424]). Multivariate Cox survival analysis (adjusting for recipient age, donor-status (living or brain-dead), pre-transplantation RBC transfusion) shows that HSA development is not associated with early RBC transfusion (p=0.59).
We found that early RBC transfusion in the setting of ATG induction therapy does not result in HLA sensitization.
CITATION INFORMATION: Jouve T, Rigault G, Janbon B, Tetaz R, Terrier N, Masson D, Rostaing L, Malvezzi P. Impact of Early Red Blood Cell Transfusion After Kidney Transplantation on De Novo HLA Sensitization in the Setting of Antithymocyte Globulin Induction. Am J Transplant. 2016;16 (suppl 3).
To cite this abstract in AMA style:Jouve T, Rigault G, Janbon B, Tetaz R, Terrier N, Masson D, Rostaing L, Malvezzi P. Impact of Early Red Blood Cell Transfusion After Kidney Transplantation on De Novo HLA Sensitization in the Setting of Antithymocyte Globulin Induction. [abstract]. Am J Transplant. 2016; 16 (suppl 3). http://atcmeetingabstracts.com/abstract/impact-of-early-red-blood-cell-transfusion-after-kidney-transplantation-on-de-novo-hla-sensitization-in-the-setting-of-antithymocyte-globulin-induction/. Accessed September 21, 2017.
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