Background: We investigated the association between bacterial/fungal infection and increased sensitization in post-transplant kidney transplant recipients due to interaction between innate and adaptive immunity and/or decreased immunosuppression during infection episodes.
Methods: Patients who received kidney transplantation between February 2009 and March 2012 were included in the study. Patients who had graft failure within 12 weeks after transplantation and did not have both pre-and-post-transplant Luminex data were excluded from analysis. Anti-HLA antibodies by Luminex single antigen beads were obtained posttransplantation per protocol at 3and 12 months, and then annually and at the time of clinically-indicated kidney biopsies. Increased sensitization was defined as increased panel reactive antibody (PRA) titers and/or mean fluorescence intensity (MFI) values of donor-specific anti-HLA antibodies (DSA) or development of new DSAs.
Results: 225 patients were included in the study and 81 patients demonstrated increased sensitization during a follow-up up to 2 years after transplantation. 69 patients developed infection; 40 urinary tract infection, 15 pneumonia, 10 sepsis, and 4 other infections. The risk factors for increased sensitization after transplantation were summarized in the Table. The only statistically significant factor for increased sensitization was history of rejection prior to or within 2 months after Luminex data. There was no association with the other factors studied including infection.
Conclusion: Acute rejection but not infection is associated with development of increased sensitization after kidney transplantation in our cohort of patients.
|Characteristic (%) or mean ± standard deviation||No change in sensitization (N=144)||Increased sensitization (N=81)||p-value|
|Infection prior to or within 2 months after sensitization date||22.0||29.6||0.22|
|Infection prior to sensitization date||21.5||23.3||0.92|
|Graft rejection prior to or w/in 2 months after sensitization date||4.9||12.4||0.04|
|Blood transfusion given prior to sensitization date||36.7||39.7||0.76|
|ESRD due to DM||32.1||32.1||0.99|
|Donor type, deceased-donor||62.5||67.9||0.41|
|Pretransplant class I PRA > 79%||11.6||19.2||0.17|
|Pretransplant class II PRA > 79%||10.4||14.8||0.33|
|Pretransplant DSA present||18.1||30.6||0.10|
To cite this abstract in AMA style:Aljanabi A, Kayler L, Colovai A, Masiakos P, Ajaimy M, Akalin E. Lack of Association between Infection and Increased Sensitization in Kidney Transplant Recipients [abstract]. Am J Transplant. 2013; 13 (suppl 5). http://atcmeetingabstracts.com/abstract/lack-of-association-between-infection-and-increased-sensitization-in-kidney-transplant-recipients/. Accessed September 23, 2017.
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