Importance of HLA-DR Expression in Pediatric Renal Transplant Biopsies.
Medical University of South Carolina, Charleston
Meeting: 2017 American Transplant Congress
Abstract number: D172
Session Information
Session Name: Poster Session D: Kidney: Pediatric
Session Type: Poster Session
Date: Tuesday, May 2, 2017
Session Time: 6:00pm-7:00pm
Presentation Time: 6:00pm-7:00pm
Location: Hall D1
Objective
To determine which types of injuries in pediatric kidney transplant patients were associated with HLA-DR expression.
Design/Methods
A retrospective chart review was conducted of children receiving a kidney transplant biopsy between January, 1st of 2011 to October, 31st of 2016. Inclusion required recipients to have at least received one kidney transplant biopsy and be under the age of 18 at the time of transplant. Data was collected using medical records.
Results
There were a total of 41 pediatric kidney transplant recipients with 117 biopsies eligible for review. There was no difference in HLA-DR expression between bACR and pure AMR. There was an increased HLA-DR expression with ACR and mixed AMR/ACR. Interestingly, the GFR was lower and there was more fibrosis in the HLA-DR positive group. There was some HLA-DR expression with BK positive biopsies and pyelonephritis, but not with isometric vacuolization.
| HLA-DR positive (n=28) | HLA-DR negative (n=89) | P-value | |
| bACR | 4(14.3%) | 4(4.5%) | 0.09 |
| ACR | 7(25%) | 3(3.4%) | 0.0017 |
| AMR | 3(10.7%) | 4(4.5%) | 0.35 |
| ACR/AMR | 9(32.1%) | 1(1.1%) | 0.0001 |
| Isometric Vacuolization | 0 | 2(2.2%) | 1 |
| BK | 1(3.6%) | 1(1.1%) | 0.42 |
| Pylonephritis | 2(7.1%) | 1(1.1%) | 0.14 |
| GFR(ml/min/1.73m2) | 52.7(+/-6.5) | 86.3(+/-3.6) | 0.0001 |
| IFTA (ct+ci) | 2.72(+/-0.28) | 1.72(+/-0.15) | 0.0024 |
| Time from BTransplant to Biopsy(mo) | 41.76(+/-9.87) | 65.92(+/-5.96) | 0.04 |
Conclusions
These results suggest that HLA-DR expression in renal tubular epithelia cells was associated more with rejection than just tubular injury and was seen more with ACR and mixed ACR/AMR. HLA-DR expression was also seen more in biopsies with longer times from transplant and is also associated with lower GFR and more fibrosis suggesting it might me more associated with later rejection episodes.
CITATION INFORMATION: Moussa O, Self S, Twombley K. Importance of HLA-DR Expression in Pediatric Renal Transplant Biopsies. Am J Transplant. 2017;17 (suppl 3).
To cite this abstract in AMA style:
Moussa O, Self S, Twombley K. Importance of HLA-DR Expression in Pediatric Renal Transplant Biopsies. [abstract]. Am J Transplant. 2017; 17 (suppl 3). https://atcmeetingabstracts.com/abstract/importance-of-hla-dr-expression-in-pediatric-renal-transplant-biopsies/. Accessed November 22, 2024.« Back to 2017 American Transplant Congress