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Angiotensin II Type 1 Receptor Antibodies Are Associated with Allograft Loss in Pediatric Renal Transplantation.

M. Pearl,1 Q. Zhang,2 M. Palma Diaz,3 J. Grotts,4 J. Brook,4 D. Gjertson,2 P. Weng,1 E. Reed,2 E. Tsai.1

1Pediatrics, University of California-Los Angeles, Los Angeles, CA
2Pathology and Laboratory Medicine, University of California-Los Angeles, Los Angeles, CA
3Anatomic & Clinical Pathology, University of California-Los Angeles, Los Angeles, CA
4Biostatistics, University of California-Los Angeles, Los Angeles, CA.

Meeting: 2016 American Transplant Congress

Abstract number: 230

Keywords: Antibodies, Graft survival, Kidney transplantation, Pediatric

Session Information

Date: Monday, June 13, 2016

Session Name: Concurrent Session: Kidney: Pediatrics

Session Time: 2:30pm-4:00pm

 Presentation Time: 3:06pm-3:18pm

Location: Room 311

Related Abstracts
  • Pretransplant Antibodies Against Angiotensin II Type 1 Receptor in Renal Transplantation: Preliminary Data from the KNOW-KT Study
  • Anti-Angiotensin Type 1 Receptor Antibodies Associated with Rejection in Donor HLA Antibody Negative Recipients

Background: Angiotensin II type 1 receptor antibody (AT1R-Ab) is associated with vascular injury and allograft failure in adult kidney transplantation. Its role in pediatric transplantation remains unknown. We aimed to determine the clinical impact of AT1R-Ab in pediatric kidney transplant recipients.

Methods: 65 pediatric patients were monitored at transplant and for 2 years post-transplant from August 2005 to November 2014 for human leukocyte antigen (HLA) donor specific antibodies (DSA) and AT1R-Ab. AT1R-Ab (ELISA test) and HLA DSA (Luminex bead assay) were measured pre-transplant, 6 months (m), 12m, 24m post-transplant and during episodes of kidney transplant rejection. A value >17 units/ml was considered positive for AT1R-Ab, while MFI cut off >1000 was considered positive for HLA DSA. Biopsies (Bxs) were performed at 6m, 12m, 24m post-transplant per protocol and for clinical suspicion of rejection. Bxs were evaluated using the 2013 Banff criteria. Clinical risk factors, renal function, hypertension, and allograft loss were monitored.

Results: The prevalence of AT1R-Ab was 58%. AT1R-Ab was negative in 40%, de novo in 34%, and preformed in 26% of patients. AT1R-Ab was associated with tubulitis (p=0.022), but not C4d positivity, peritubular capillaritis, or arteritis (data not shown). AT1R-Ab was not associated with any identifiable risk factors, including the presence of HLA DSA (Figure 1a). AT1R-Ab was associated with allograft loss (p=0.036, Figure 1b), but not hypertension or decline in eGFR by 50% (data not shown).

Conclusions: AT1R-Ab is highly prevalent in pediatric renal transplant recipients and is a risk factor for graft loss independent of HLA DSA. AT1R-Ab monitoring should be considered in pediatric renal transplant recipients.

CITATION INFORMATION: Pearl M, Zhang Q, Palma Diaz M, Grotts J, Brook J, Gjertson D, Weng P, Reed E, Tsai E. Angiotensin II Type 1 Receptor Antibodies Are Associated with Allograft Loss in Pediatric Renal Transplantation. Am J Transplant. 2016;16 (suppl 3).

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To cite this abstract in AMA style:

Pearl M, Zhang Q, Diaz MPalma, Grotts J, Brook J, Gjertson D, Weng P, Reed E, Tsai E. Angiotensin II Type 1 Receptor Antibodies Are Associated with Allograft Loss in Pediatric Renal Transplantation. [abstract]. Am J Transplant. 2016; 16 (suppl 3). https://atcmeetingabstracts.com/abstract/angiotensin-ii-type-1-receptor-antibodies-are-associated-with-allograft-loss-in-pediatric-renal-transplantation/. Accessed February 27, 2021.

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