Are AT1R Antibodies as Dangerous as HLA-DSAs in Renal Allografts?
1Transplantation, 1aNephrology-Mineral Metabolism, Inst Nal de Ciencias Medicas y Nutricion SZ, Mexico City, Distrito Federal, Mexico.
Meeting: 2015 American Transplant Congress
Abstract number: A96
Keywords: Antibodies, Graft function, Kidney transplantation, Rejection
Session Information
Session Name: Poster Session A: Kidney Antibody Mediated Rejection
Session Type: Poster Session
Date: Saturday, May 2, 2015
Session Time: 5:30pm-7:30pm
Presentation Time: 5:30pm-7:30pm
Location: Exhibit Hall E
Angiotensin II type 1 receptor antibodies (AT1Rab) have been associated with a significantly lower graft survival and a higher risk of acute rejection after kidney transplantation. We previously reported a significantly lower eGFR (mL/min/1.73m2) at 1 & 12mos posttransplant, in a group of living donor (LD) kidney transplant recipients (KTR) who tested positive for AT1Rab (>17IU) & without HLA-DSA in pre-transplant sera, compared with a group of LD KTR with neither AT1Rab nor HLA-DSA. Methods. We prospectively gathered post-transplant blood samples from these patients in order to evaluate the incidence of both de novo AT1Rab & de novo HLA-DSA. Herein, we report the follow-up outcomes >12mos of this patient population in terms of graft function, and acute rejection (AR) according to pre- and posttransplant Ab status. Results. This study included 115 KTR. For analysis purposes, patients were divided into 4 groups: 1)with neither pre or post-transplant AT1Rab or HLA-DSA (w/o Abs), 2)AT1Rab+ve pre- and/or post-transplant, 3)HLA-DSA+ve pre-and/or post-transplant, 4)both AT1Rab and HLA-DSA+ve pre-and/or post-transplant. There were no differences in demographic characteristics between the groups, except for thymoglobulin induction of HLA-DSA+ve patients. Graft function follow-up and acute rejection (AR) rates are depicted in Table 1.
| w/o Abs (n=57) | AT1Rab+ve (n=18) | HLA-DSA+ (n=28) | AT1Rab + HLA DSA (n=12) | P | |
| Follow-up period (mos) | 37.6 (±13.4) | 37.7 (±19.04) | 36.7 (±11.4) | 39.4 (±17.3) | 0.95 |
| eGFR at mo 12 | 73.2 (±18.2) | 68.4 (±16.9) | 65.5 (±22.2) | 60.5 (±16.8) | 0.109 |
| eGFR at last follow-up | 64.3 (±19.1) | 64.1 (±17.2) | 57.4 (±23) | 53.3 (±22.2) | 0.20 |
| δ eGFR (mo3 – last f-u) | -8.52 (±20.2) | -6.5 (±15.1) | -13.2 (±19.9) | -14.3 (±16.3) | 0.48 |
| AR events (all), n(%) | 12(21.8) | 3(17.65) | 13(43.3) | 8(61.5) | 0.011 |
| AR (excl borderline) | 4(7.27) | 1(5.88) | 9(30.0) | 3(23.1) | 0.020 |
| Borderline | 8(66.6 ) | 2(66.6) | 4(30.7) | 5(62.5) | |
| Cellular AR | 1(8.33) | 1(33.3) | 3(23.1) | 1(12.5) | |
| Humoral AR | 2(16.6) | 0(0) | 4(30.7) | 1(12.5) | |
| Mixed AR | 1(8.3) | 0(0) | 2(15.4) | 1(12.5) |
Conclusions. A significantly higher AR rate and a non-significant lower eGFR were observed at follow-up in KTR positive for HLA-DSA, independently of AT1Rab positivity. In fact, positive KTR for only pre- and/or post-transplant AT1Rabs, behave similarly to KTR w/o antibodies. These findings warrant a longer follow-up of these study groups.
To cite this abstract in AMA style:
Cuevas E, Arreola-Guerra J, Hernandez-Mendez E, Salcedo I, Vilatoba M, Contreras A, Sanchez-Cedillo A, Ramirez J, Rungs Dde, Granados J, Morales-Buenrostro L, Alberu J. Are AT1R Antibodies as Dangerous as HLA-DSAs in Renal Allografts? [abstract]. Am J Transplant. 2015; 15 (suppl 3). https://atcmeetingabstracts.com/abstract/are-at1r-antibodies-as-dangerous-as-hla-dsas-in-renal-allografts/. Accessed November 21, 2024.« Back to 2015 American Transplant Congress