Purpose: To evaluate the association of plasma cell population (PCs) in splenic histology of ABO incompatible (ABO-i) kidney transplant recipients and one year graft and patient survival.
Methods: We reviewed the clinical data and cellular population in the spleen of 29 recipients with an ABO-i kidney transplantation who underwent pre-emptive splenectomy from 2005 to 2011. The splenic histology was analyzed by immunohistochemistry. For comparison, we distributed the recipients into two groups according to the total PCs population obtained from the spleen. The cutoff point criteria for the two groups was that of being greater and below 2% for the PCs population.
Results: Eighteen recipients constituted the group of PCs population greater than 2%, as compared with eleven recipients in the group with a lower population. Within the first year after transplantation, three (16.7%) recipients presented graft loss and three (16.7%) recipients died in the group with the higher presence of PCs, as compared with no recipients with graft loss and who died in the group with the lower PCs population. Initial isoagglutinin titers higher than 1:32 prior to desensitization therapy were present in two (67%) recipients who experienced graft loss and in three (100%) deceased recipients [Table 1].
Conclusions: ABO-i kidney transplant recipients with PCs population lower than 2% and initial isoagglutinin titers less than 1:32 had a higher probability of successful graft function and survival within one-year post-transplant. We did not find an association between the amount of desensitization therapy needed to decrease isoagglutinin titers and that of recipient outcomes.
|Risk factors||PCs > 2% group||PCs < 2% group|
|Prior transplantation, n (%)||2 (11)||0 (0)|
|Prior transfusion, n (%)||1 (5.6)||0 (0)|
|Pregnancy, n (%)||6/9 (66.7)||3/4 (75)|
|Pre-plasmapheresis issoagglutinins titers > 1:32, n (%)||17 (94.4)||8 (72.7)|
|Total PCs %, mean (SD)||5 (3.8)||1(0.52)|
|Outcome at one-year post-transplant|
|ACR n (%)||5 (27.7)||3 (27.3)|
|AMR, n (%)||2 (11.1)||3 (27.3)|
|Graft loss, n (%)||3 (16.7)||0 (0)|
|Recipients deceased, n (%)||3 (16.7)||0 (0)|
To cite this abstract in AMA style:Tzvetanov I, Bejarano-Pineda L, Setty S, Harbhajanka A, Khan A, Jeon H, Garcia-Roca R, Oberholzer J, Benedetti E. Association of B Cell Population in Splenic Histology of ABO Incompatible Kidney Transplantation and One-Year Graft and Recipient Survival, The [abstract]. Am J Transplant. 2013; 13 (suppl 5). https://atcmeetingabstracts.com/abstract/association-of-b-cell-population-in-splenic-histology-of-abo-incompatible-kidney-transplantation-and-one-year-graft-and-recipient-survival-the/. Accessed October 27, 2020.
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