A Low Level of De Novo DSA Sialylation is Associated with a Decreased of Allograft Survival in Non-Sensitized Kidney Transplant Recipients

M. Bonnet,^1,2 V. Pernin,^1,3 J-.E. Serre,¹ V. Georgescu,⁴ M. Le Quintrec,^1,2,3 G. Mourad,^1,2 J-.F. Eliaou,^2,5 C. Rene.^2,5

¹Nephrology, Dialysis and Transplantation, Hôpital Lapeyronie, Montpellier University Hospital, Montpellier, France
²University of Medicine, Montpellier University, Montpellier, France
³Inserm U1183, IRMB, Hôpital Saint Eloi, Montpellier University Hospital, Montpellier, France
⁴Department of Medical Information, Montpellier University Hospital, Montpellier, France
⁵Department of Immunology, Hôpital Saint Eloi, Montpellier University Hospital, Montpellier, France.

Meeting: 2018 American Transplant Congress

Abstract number: 511

Keywords: HLA antibodies, Kidney transplantation, Survival

Session Information

Session Name: Concurrent Session: Kidney Complications: Antibody & Late Outcomes

Session Type: Concurrent Session

Date: Tuesday, June 5, 2018

Session Time: 4:30pm-6:00pm

Presentation Time: 5:06pm-5:18pm

Location: Room 4B

Background. In kidney transplantation, de novo donor specific antibodies (dnDSA) are associated with antibody-mediated rejection (ABMR) and graft failure. While appearance of dnDSA, there is a great variability in outcomes. Sialylation status of antibodies was previously shown to modulate the effector function. The objective of our study was to evaluate the impact of DSA sialylation on allograft survival in non-sensitized kidney transplant recipients.

Methods. The cohort included 296 non-sensitized patients, who underwent a first kidney transplant between 2008 and 2014 in our center. For patients developing dnDSA (44 individuals),we analyzed immunodominant DSA sialylation on the first DSA detection sera and one year after using affinity chromatography with lectin. Primary endpoint was allograft failure according to immunodominant DSA sialylation status. Secondary endpoints were ABMR incidence and Banff classification scores.

Results. Eleven patients (25%) had sialylated iDSA and 33 patients had non-sialylated iDSA (75%). Patients with non-sialylated iDSA had significantly higher scores for microvascular inflammation (p = 0.02) than patients with sialylated iDSA. There was a trend for higher IF/TA score in non-sialylated group (p = 0.13). Five-year allograft survival was significantly lower in patients with non-sialylated iDSA (80.0%) compared to patients with sialylated iDSA, with non-DSA anti-HLA antibodies and without any anti-HLA immunization (90.0%, 92.2% and 95.2%, respectively; p = 0.007). In multivariate analysis, non-sialylated iDSA was independently associated with allograft failure compared with no anti-HLA antibodies (HR 4.0; IC95% [1.24; 12.90]; p = 0.02).

Conclusion. DSA sialylation status seems to be associated with allograft failure in non-sensitized kidney transplant recipients. DSA sialylation analyze may be helpful for ABMR risk assessment.

CITATION INFORMATION: Bonnet M., Pernin V., Serre J-.E., Georgescu V., Le Quintrec M., Mourad G., Eliaou J-.F., Rene C. A Low Level of De Novo DSA Sialylation is Associated with a Decreased of Allograft Survival in Non-Sensitized Kidney Transplant Recipients Am J Transplant. 2017;17 (suppl 3).

To cite this abstract in AMA style:

Bonnet M, Pernin V, Serre J-E, Georgescu V, Quintrec MLe, Mourad G, Eliaou J-F, Rene C. A Low Level of De Novo DSA Sialylation is Associated with a Decreased of Allograft Survival in Non-Sensitized Kidney Transplant Recipients [abstract]. https://atcmeetingabstracts.com/abstract/a-low-level-of-de-novo-dsa-sialylation-is-associated-with-a-decreased-of-allograft-survival-in-non-sensitized-kidney-transplant-recipients/. Accessed November 23, 2024.

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