Session Time: 2:30pm-4:00pm
Presentation Time: 2:54pm-3:06pm
Introduction: Although it is well known that blood transfusions post-transplant are associated with the development of both HLA and donor specific antibodies [DSAs] and a higher incidence of rejection, there are no studies where the HLA type of the blood donors have been correlated with the HLA type of the recipient denovo DSAs.
In this novel study we examine the development of transfusion specific HLA antibodies [TSAs] in a cohort of previously DSA- transplant recipients who were transfused post operatively and correlate their appearance with subsequent clinical outcomes.
Methods: We selected 36 patients who developed DSAs and who were transfused post transplant. We then HLA typed 108 donors who gave blood to these 36 [26m, 10F] renal  and pancreas  transplant recipients [mean HLA mm 3.7±1.5]
Results: 54/108 [50%] transfusions resulted in a TSA in 29/36 [80.6%] patients. 33/108 [30.6%] transfusions resulted in a TSA, which was the same specificity as the subsequent DSA [TSA=DSA]. The median time to blood transfusion was 2.5 [0.0-6.2] days and to DSA detection was 57.0 [17.4-160.9] days. Patients where TSA=DSA had the worse allograft outcomes as shown below
|TSA-/DSA+ [n=7]||TSA+/DSA+||p value|
|TSA[ne]DSA [n=12]||TSA=DSA [n=17]|
|Rejection free survival||57.1%||50.0%||25.5%||0.13|
|AMR free survival||100.0%||66.7%||31.9%||0.015|
Discussion: This preliminary study has shown that TSAs are common in transplant recipients despite immunosuppression. If TSAs are directed against the allograft [TSA=DSA], rejection is common and outcomes poor.
CITATION INFORMATION: Hassan S, Regan F, Brown C, Harmer A, Anderson N, Brookes P, Taube D, Willicombe M. Blood Transfusion Induced Donor Specific Antibodies Are Associated with Rejection and Graft Failure. Am J Transplant. 2017;17 (suppl 3).
To cite this abstract in AMA style:Hassan S, Regan F, Brown C, Harmer A, Anderson N, Brookes P, Taube D, Willicombe M. Blood Transfusion Induced Donor Specific Antibodies Are Associated with Rejection and Graft Failure. [abstract]. Am J Transplant. 2017; 17 (suppl 3). https://atcmeetingabstracts.com/abstract/blood-transfusion-induced-donor-specific-antibodies-are-associated-with-rejection-and-graft-failure/. Accessed February 23, 2019.
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