Date: Saturday, June 2, 2018
Session Time: 5:30pm-7:30pm
Presentation Time: 5:30pm-7:30pm
Location: Hall 4EF
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 July 16, 2019.
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