Association between Longer Hospitalization and Development of De Novo Donor Specific Antibody in Simultaneous Liver-Kidney Transplant Recipients

M. Yazawa¹, O. Cseprekal², R. A. Helmick¹, M. Talwar¹, V. Balaraman¹, P. S. Podila³, S. Fossey⁴, S. K. Satapathy⁵, J. D. Eason¹, M. Z. Molnar¹

¹James D. Eason Transplant Institute, Methodist University Hospital, Memphis, TN, ²Department of Transplantation and Surgery, Semmelweis University, Budapest, Hungary, ³Faith & Health Division, Methodist Le Bonheur Healthcare, Memphis, TN, ⁴Transplant Immunology Laboratory, DCI Inc., Nashville, TN, ⁵Sandra Atlas Bass Center for Liver Diseases & Transplantation, Northshore University Hospital/Northwell Health, Manhasset, NY

Meeting: 2020 American Transplant Congress

Abstract number: C-124

Keywords: Antibodies, HLA antibodies, Kidney/liver transplantation, Length of stay

Session Information

Session Name: Poster Session C: Liver - Kidney Issues in Liver Transplantation

Session Type: Poster Session

Date: Saturday, May 30, 2020

Session Time: 3:15pm-4:00pm

Presentation Time: 3:30pm-4:00pm

Location: Virtual

*Purpose: De novo Donor Specific Antibodies (DSA) are considered a risk factor for worsening kidney allograft outcomes in recipients after simultaneous liver-kidney transplantation (SLK). No previous study has assessed the risk factor of development of de novo DSA in SLK. We hypothesized that length of hospital stay (LHS) might be associated with the development of de novo DSA because of the higher chance of decreasing immunosuppression and receiving blood transfusions during LHS.

*Methods: This study is a single center, retrospective cohort study consisting of 85 recipients who underwent SLK from 2009 to 2018. LHS was divided into two groups according to the median of 14 days. De novo DSA was measured by solid phase assay based on the indication. Propensity score (PS) has been created using logistic regression to predict LHS. The association between the presence of de novo DSA (DSA(+)) and LHS was assessed by logistic regression models.

*Results: The mean+/SD age at transplantation of the entire cohort was 56+/10 years. Sixty and 26% of the patients were male and African-American, respectively. Eight out of 85 patients developed de novo DSA after SLK (9%). The median date of measuring de novo DSA after SLK was 53 days (IQR: 14-281). In the de novo DSA (+) group, LHS was significantly longer than de novo DSA (-) group (median 26.5 days and 13.0 days, p=0.007). Long LHS was significantly associated with a higher risk of development of de novo DSA in unadjusted (OR+ each 5 days: 1.09, 95%CI: 1.02-1.16) and PS adjusted (OR+ each 5 days : 1.11, 95%CI: 1.02-1.21) analysis.

*Conclusions: Longer hospitalization is significantly associated with the development of de novo DSA in SLKT.

To cite this abstract in AMA style:

Yazawa M, Cseprekal O, Helmick RA, Talwar M, Balaraman V, Podila PS, Fossey S, Satapathy SK, Eason JD, Molnar MZ. Association between Longer Hospitalization and Development of De Novo Donor Specific Antibody in Simultaneous Liver-Kidney Transplant Recipients [abstract]. Am J Transplant. 2020; 20 (suppl 3). https://atcmeetingabstracts.com/abstract/association-between-longer-hospitalization-and-development-of-de-novo-donor-specific-antibody-in-simultaneous-liver-kidney-transplant-recipients/. Accessed May 11, 2025.

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