ABO-Incompatibility Lower Incidence of DSA-Induced Antibody-Mediated Rejection
1Nephrology, Medicine, Maryknoll General Hospital, Busan, Republic of Korea
2Laboratory Medicine, Maryknoll General Hospital, Busan, Republic of Korea
3Surgery, Maryknoll General Hospital, Busan, Republic of Korea
4Urology, Maryknoll General Hospital, Busan, Republic of Korea
5Pathology, Maryknoll General Hospital, Busan, Republic of Korea.
Meeting: 2018 American Transplant Congress
Abstract number: A129
Keywords: Alloantibodies, Kidney transplantation, MHC class II, Rejection
Session Information
Session Name: Poster Session A: Kidney Acute Antibody Mediated Rejection
Session Type: Poster Session
Date: Saturday, June 2, 2018
Session Time: 5:30pm-7:30pm
Presentation Time: 5:30pm-7:30pm
Location: Hall 4EF
Introduction:
Donor-specific anti-HLA antibody (DSA) and Anti-ABO antibody are major barriers for successful kidney transplantation. Limited data are available about the existences of both DSA and anti-ABO antibody has an influence on the development of ABMR. Lower incidence of DSA-induced chronic AMR in ABO-incompatible kidney transplantation which suggested anti-ABO antibody lower DR expression and de novo DSA production. Also ABOiKT and the decreased likelihood of developing immune responses to HLA and kidney self-antigens. Purpose of our study is to compare DSA development and incidence of DSA-induced ABMR between ABOiKT and ABOcKT.
Method: We examined 206 stable kidney transplant recipients (175 ABO compatible-KTRs and 31 ABO incompatible-KTRs) for development of DSAs from June 2013 to June 2017. We biopsied 34 recipients who had DSAs on Luminex PRA. We compared clinical outcomes and incidence of DSA-induced AMR in between ABO-incompatible KT and ABO-compatible KT.
Result:34 of 206 stable KTRs (16.5%) had PRA-DSAs, Median time of DSA occurring was 5.3(0.1-21.4) year of post-transplantation. Median peak MFI level was 1514.5(151-17453). The incidence of AMR was 6.8 %( 14 of 206). Compared with ABO-compatible KTR, incidence of DSA occurrence was significantly higher (41.9%, 13of 31 vs. 12.0%, 21of 175, P<0.001) and earlier (2.1±2.1year vs. 9.4±6.3year, P=0.001, Mann-Whitney test) after transplantation, however, DSA-induced AMR development was significantly lower in ABO-incompatible KTR (15.4%, 2of 13 vs. 57.1%, 12of 21, P=0.018). HLA mismatch number (3.93±1.5 vs. 3.2±1.4, P=0.007), female donor (64.5% vs.39.1%, P=0.008) and living unrelated donor rate (76.7% vs. 30.2%, P=0.001) were significantly higher in ABO-incompatible KTR.
Conclusion: Our study showed that DSA occurrence was earlier and higher rate in ABO-incompatible kidney transplantation, even after ABO-incompatible KTR were desensitized with PP, low dose IVIG, and Rituximab. However, the incidence of DSA-induced AMR was significantly lower in ABO-incompatible KTR which imply ABO incompatibility have possible protective effect against the development of AMR.
CITATION INFORMATION: Lee D., Kim B., KIm J., KIm I., Jeon M. ABO-Incompatibility Lower Incidence of DSA-Induced Antibody-Mediated Rejection Am J Transplant. 2017;17 (suppl 3).
To cite this abstract in AMA style:
Lee D, Kim B, KIm J, KIm I, Jeon M. ABO-Incompatibility Lower Incidence of DSA-Induced Antibody-Mediated Rejection [abstract]. https://atcmeetingabstracts.com/abstract/abo-incompatibility-lower-incidence-of-dsa-induced-antibody-mediated-rejection/. Accessed May 8, 2025.« Back to 2018 American Transplant Congress