Presence of Complement Activating Donor Specific Antibodies Is Associated with Poor Renal Allograft Survival: Two Centre Retrospective Study.
1Warwick Medical School, University of Warwick, Coventry, United Kingdom
2Clinical Transplantation Laboratories, Guy's Hospital, Viapath, London, United Kingdom
3Nephrology and Transplantation, Guy's Hospital, London, United Kingdom
4Histocompatibility and Immunogenetics, NHS Blood and Transfusion, Birmingham, United Kingdom
5Nephrology and Transplantation, University Hospitals Coventry and Warwickshire, Coventry, United Kingdom
6Nephrology and Transplantation, Leeds Teaching Hospitals NHS Trust, Leeds, United Kingdom
Meeting: 2017 American Transplant Congress
Abstract number: A54
Keywords: Alloantibodies, Graft survival, HLA antibodies, Kidney transplantation
Session Information
Session Name: Poster Session A: Clinical Science: Kidney Immunosuppression: Desensitization
Session Type: Poster Session
Date: Saturday, April 29, 2017
Session Time: 5:30pm-7:30pm
Presentation Time: 5:30pm-7:30pm
Location: Hall D1
Introduction: Complement fixing donor specific antibodies (DSA) as detected by presence of C3d at the time of rejection is associated with poor graft outcome;no studies have explored the role pre-transplant; especially in Human leucocyte Antigen- Antibody incompatible transplants (HLA-AIT).Methods: Analysed 117 patient samples either complement dependent cytotoxicity (CDC) or Flow Crossmatch(FC) positive at pre-conditioning who underwent direct transplantation after desensitisation. C3d (Immucor) assay was performed and the results correlated with early antibody mediated rejection (EAMR) (within first 30 days) and death censored allograft survival (DCGF). Results: Of 117 cases, C3d positive DSAs were present in 49 (42%) cases and there was trend towards predication of EAMR, although statistical significance not reached (p 0.70).
| Status | Early AMR | No Rejection |
| C3d positive (49) | 20 | 29 |
| C3d negative (68) | 26 | 42 |
| 46 | 71 |
C3d DSA correlated significantly with poor DCGF (p < 0.001) 
The five-year DCGF was 56 % in C3d positive group compared to 86% in negative group.
Discussion: Presence of pre-transplant C3d DSA strongly predicts renal allograft survival. Allograft survival in C3d negative patients is comparable to non-sensitised living donor transplants. This enables the differentiation of IgG antibodies of varying pathogenicity and the potential role of C3d as additional biomarker in pre-transplant workup. Mutivariate analysis is being performed and will be presented at the meeting.
CITATION INFORMATION: Babu A, Shaw O, Howe L, Kessaris N, Dorling A, Mamode N, Vaughan R, Krishnan N, Higgins R, MItchell D, Briggs D, Daga S. Presence of Complement Activating Donor Specific Antibodies Is Associated with Poor Renal Allograft Survival: Two Centre Retrospective Study. Am J Transplant. 2017;17 (suppl 3).
To cite this abstract in AMA style:
Babu A, Shaw O, Howe L, Kessaris N, Dorling A, Mamode N, Vaughan R, Krishnan N, Higgins R, MItchell D, Briggs D, Daga S. Presence of Complement Activating Donor Specific Antibodies Is Associated with Poor Renal Allograft Survival: Two Centre Retrospective Study. [abstract]. Am J Transplant. 2017; 17 (suppl 3). https://atcmeetingabstracts.com/abstract/presence-of-complement-activating-donor-specific-antibodies-is-associated-with-poor-renal-allograft-survival-two-centre-retrospective-study/. Accessed November 22, 2024.« Back to 2017 American Transplant Congress