Date: Saturday, June 11, 2016
Session Time: 5:30pm-7:30pm
Presentation Time: 5:30pm-7:30pm
Location: Halls C&D
Background:Anti-HLA antibodies are risk factors for acute and chronic rejection and allograft loss. Its detection represents a major advance and is widely used in organ allocation and pretransplant risk assessment. Our aim was to understand the impact of preformed anti-HLA antibodies on clinical outcomes. Methods:We enrolled 102 aleatory patients who received a kidney transplant (KT) from 2010 to 2015, at our Center. Donor–recipient pairs were typed for HLA-A, B, DR, and DQ before transplantation. All patients were transplanted with a negative cytotoxic crossmatch. We divided the patients in three groups: a) group with no anti-HLA antibodies (n=54), b) group with non-donor-specific antibody (NDSA) (n=28) and c) group with donor-specific antibody (DSA) (n=20). Results:Table 1 compares the characteristics of the three groups.
|No anti-HLA antibodies,N=54||NDSA,N=28||DSA,N=20||P|
|HLA total mismatches||3.22±1.50||3.29±1.30||3.30±1.38||0.97|
|Median calculated PRA cytotoxic (range)||0||78.9(10.1-100)||82.8(4.1-100)||<0.001|
Acute rejection incidence was higher in DSA group (35% vs. 11% in NDSA group and vs. 7.5% in group with no anti-HLA antibodies, P=0.01). This was primarily due to antibody-mediated rejection (AMR). Graf function assessment using MDRD calculation at month 3, month 6 and then annually indicated that at the 4th year the DSA group had significantly lower glomerular filtration rate (median in DSA group was 43.2mL/min, in NDSA group was 46.3mL/min and in group with no anti-HLA antibodies was 55.7mL/min, P<0.05). At the end of the follow-up only 7 patients lost their grafts and death occurred in 9 patients: no statistically significant difference between groups. Conclusions:Patients transplanted with DSA presented a higher incidence of AMR and lower graft function at 4-years. Nevertheless, no clear effect of preformed anti-HLA antibodies (DSA or non-DSA) on mid-term kidney graft survival was observed.
CITATION INFORMATION: Santos S, Malheiro J, Costa M, Campos A, Pedroso S, Almeida M, Martins L, Dias L, Henriques C, Cabrita A. Impact of Preformed Anti-HLA Antibodies in the Outcomes of Kidney Transplantation. Am J Transplant. 2016;16 (suppl 3).
To cite this abstract in AMA style:Santos S, Malheiro J, Costa M, Campos A, Pedroso S, Almeida M, Martins L, Dias L, Henriques C, Cabrita A. Impact of Preformed Anti-HLA Antibodies in the Outcomes of Kidney Transplantation. [abstract]. Am J Transplant. 2016; 16 (suppl 3). http://atcmeetingabstracts.com/abstract/impact-of-preformed-anti-hla-antibodies-in-the-outcomes-of-kidney-transplantation/. Accessed September 21, 2017.
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