Allograft nephrectomy is a major risk factor for alloimmunization and can increase time on the waiting-list and acute antibody-mediated rejection. Anti-HLA immunization profile, DSA and non-DSA, remains incompletely studied.
We retrospectively analyzed anti-HLA DSA and non-DSA, using Luminex technology, in 58 patients presented with allograft nephrectomy between 2005 and 2010. For each patient, anti-HLA antibodies were assessed at the time of nephrectomy, 3 and 12 months after.
We defined three groups of patients according to nephrectomy clinical background: group 1A- late nephrectomy (> 6 months) and intolerance graft syndrome (N=32), group 1B asymptomatic late nephrectomy (N=13) and group 2 early nephrectomy (< 6 months) (N=13).
At the time of nephrectomy, class II non-DSA were similar in group 1A and 1B but group 1A has significantly more class I non-DSA (MFI > 1000, > 3000 and > 6000) than group 1B (P=0.03 ; 0.05 and 0.03 respectively). MFI max class I DSA was significantly higher in group 1A (p=0.003). After 3 and 12 months, median number of class I non-DSA with MFI > 1000 increased significantly in group 1A (N=15) with peak reached after 3 months. After 12 months, group 1B (N=12) showed bimodal evolution: median number of anti-HLA non-DSA with MFI > 3000 increased significantly for 60% of patients and 40% were stables. Class II non-DSA were on steady state before nephrectomy and after 12 months. All patients developed all DSA after 12 months. Calculated PRA (cPRA) did not increase in both groups at 12 months. At the time of nephrectomy, patients from group 2 (N=10) exhibited significantly less anti-HLA antibodies. Median number of anti-HLA non-DSA with MFI > 1000 increased significantly after 3 and 12 months (P=0.02 and 0.04). Sixty six percent of patients developed all DSA after 12 months with MFI max > 6000 for all of them. cPRA increased significantly at 12 months (p=0.0005).
Our results confirmed that renal allograft nephrectomy is a major risk factor of DSA and non-DSA HLA immunization. Clinical background at the time of nephrectomy clearly influences anti-HLA antibodies. To optimize strategies to prevent alloimmunization at the time of renal allograft nephrectomy, we need to consider this parameter.
To cite this abstract in AMA style:Leibler-Romand C, Matignon M, Roudot-Thoraval F, Salomon L, Charron D, Lang P, Suberbielle C, Grimbert P. Anti-HLA Immunization Profile at the Time and after Renal Allograft Nephrectomy [abstract]. Am J Transplant. 2013; 13 (suppl 5). https://atcmeetingabstracts.com/abstract/anti-hla-immunization-profile-at-the-time-and-after-renal-allograft-nephrectomy/. Accessed October 27, 2020.
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