Circulating De Novo Donor Specific Antibodies and Carotid Intima-Media Thickness in Pediatric Kidney Transplant Recipients
1Nephrology, Children's National, Washington DC, DC, 2Cardiology, Children's National, Washington DC, DC
Meeting: 2019 American Transplant Congress
Abstract number: C230
Keywords: Antibodies, Arteriosclerosis, Kidney, Pediatric
Session Information
Session Name: Poster Session C: Kidney: Pediatrics
Session Type: Poster Session
Date: Monday, June 3, 2019
Session Time: 6:00pm-7:00pm
Presentation Time: 6:00pm-7:00pm
Location: Hall C & D
*Purpose: Emerging evidence suggests that circulating de novo donor specific anti-HLA antibodies (dnDSA) may be associated with increased risk of accelerated systemic arteriosclerosis and major cardiovascular (CV) events in adults (Loupy et al. Circ Res. 2015:117:470-482), but this has not been studied in children. The purpose of this study was to investigate association of dnDSA with carotid intima-media thickness (CIMT) in pediatric kidney transplant recipients.
*Methods: This prospective controlled cohort study included 38 pediatric kidney transplant recipients and 20 race-matched healthy controls. Participants had CIMT, blood pressure, and lipid panel measured at 18 and 30 months post-transplant, and monitoring for dnDSA occurred at 6, 18, and 30 months post-transplant. CIMT of transplant recipients with dnDSA was compared to CIMT of transplant recipients without dnDSA and to controls by Wilcoxon rank-sum. Additionally, multivariate analysis for association of CIMT with dnDSA, after adjustment for age, sex, African American race, hypertension, and dyslipidemia was performed by generalized estimating equation (GEE) regression.
*Results: Of 38 transplant recipients (age 11.3+0.7 years), 8 patients (21%) developed dnDSA. Transplant recipients with dnDSA had higher CIMT (0.49cm) compared to those without dnDSA (0.45cm), p=0.03 (see Figure). CIMT of those without dnDSA did not differ from race-matched healthy controls (0.45 cm). Results of the multivariate analysis are shown in the Table. Children with dnDSA had 5.5% higher CIMT compared to those without dnDSA, after adjusting for African American race, sex, age, hypertension, and dyslipidemia. In addition, African American transplant recipients had 9.2% higher CIMT than transplant recipients of other races. Hypertension and dyslipidemia were not significant in the multivariate analysis.
*Conclusions: Circulating dnDSA are associated with increased CIMT in pediatric kidney transplant recipients, after adjusting for traditional CV risk factors.
| Variable | % change in CIMT(95% CI) | p value |
| dnDSA | 5.5(1.4-9.7) | 0.009 |
| African American race | 9.2(5.7-12.8) | 0.0001 |
| Hypertension | 1.5(-1.9-5.1) | 0.37 |
| Dyslipidemia | 0.5(-2.7-3.9) | 0.73 |
| Sex | -1.2(-4.9-2.4) | 0.51 |
| Age | -1.2(-4.6-2.2) | 0.49 |
To cite this abstract in AMA style:
Sgambat K, Clauss S, Moudgil A. Circulating De Novo Donor Specific Antibodies and Carotid Intima-Media Thickness in Pediatric Kidney Transplant Recipients [abstract]. Am J Transplant. 2019; 19 (suppl 3). https://atcmeetingabstracts.com/abstract/circulating-de-novo-donor-specific-antibodies-and-carotid-intima-media-thickness-in-pediatric-kidney-transplant-recipients/. Accessed November 22, 2024.« Back to 2019 American Transplant Congress