Association between Longer Hospitalization and Development of De Novo Donor Specific Antibody in Simultaneous Liver-Kidney Transplant Recipients
1James D. Eason Transplant Institute, Methodist University Hospital, Memphis, TN, 2Department of Transplantation and Surgery, Semmelweis University, Budapest, Hungary, 3Faith & Health Division, Methodist Le Bonheur Healthcare, Memphis, TN, 4Transplant Immunology Laboratory, DCI Inc., Nashville, TN, 5Sandra Atlas Bass Center for Liver Diseases & Transplantation, Northshore University Hospital/Northwell Health, Manhasset, NY
Meeting: 2020 American Transplant Congress
Abstract number: C-124
Keywords: Antibodies, HLA antibodies, Kidney/liver transplantation, Length of stay
Session Information
Session Name: Poster Session C: Liver - Kidney Issues in Liver Transplantation
Session Type: Poster Session
Date: Saturday, May 30, 2020
Session Time: 3:15pm-4:00pm
Presentation Time: 3:30pm-4:00pm
Location: Virtual
*Purpose: De novo Donor Specific Antibodies (DSA) are considered a risk factor for worsening kidney allograft outcomes in recipients after simultaneous liver-kidney transplantation (SLK). No previous study has assessed the risk factor of development of de novo DSA in SLK. We hypothesized that length of hospital stay (LHS) might be associated with the development of de novo DSA because of the higher chance of decreasing immunosuppression and receiving blood transfusions during LHS.
*Methods: This study is a single center, retrospective cohort study consisting of 85 recipients who underwent SLK from 2009 to 2018. LHS was divided into two groups according to the median of 14 days. De novo DSA was measured by solid phase assay based on the indication. Propensity score (PS) has been created using logistic regression to predict LHS. The association between the presence of de novo DSA (DSA(+)) and LHS was assessed by logistic regression models.
*Results: The mean+/SD age at transplantation of the entire cohort was 56+/10 years. Sixty and 26% of the patients were male and African-American, respectively. Eight out of 85 patients developed de novo DSA after SLK (9%). The median date of measuring de novo DSA after SLK was 53 days (IQR: 14-281). In the de novo DSA (+) group, LHS was significantly longer than de novo DSA (-) group (median 26.5 days and 13.0 days, p=0.007). Long LHS was significantly associated with a higher risk of development of de novo DSA in unadjusted (OR+ each 5 days: 1.09, 95%CI: 1.02-1.16) and PS adjusted (OR+ each 5 days : 1.11, 95%CI: 1.02-1.21) analysis.
*Conclusions: Longer hospitalization is significantly associated with the development of de novo DSA in SLKT.
To cite this abstract in AMA style:
Yazawa M, Cseprekal O, Helmick RA, Talwar M, Balaraman V, Podila PS, Fossey S, Satapathy SK, Eason JD, Molnar MZ. Association between Longer Hospitalization and Development of De Novo Donor Specific Antibody in Simultaneous Liver-Kidney Transplant Recipients [abstract]. Am J Transplant. 2020; 20 (suppl 3). https://atcmeetingabstracts.com/abstract/association-between-longer-hospitalization-and-development-of-de-novo-donor-specific-antibody-in-simultaneous-liver-kidney-transplant-recipients/. Accessed November 24, 2024.« Back to 2020 American Transplant Congress