Date: Saturday, April 29, 2017
Session Time: 5:30pm-7:30pm
Presentation Time: 5:30pm-7:30pm
Location: Hall D1
Despite advances in therapeutic strategies and medicine, antibody mediated rejection (AMR) is a leading cause of kidney graft loss. The complement binding activity of donor-specific antibodies (DSA) has been suggested as a new tool to stratify immunologic risk. In this study, we evaluated the diagnostic value of C3d or C1q binding activity of de novo DSA (dnDSA) for predicting AMR in non-sensitized kidney transplantation.
A total of 165 nonsensitized recipients were monitored for dnDSA at the time of protocol or indication biopsy. Twenty-five (15.2%) patients were diagnosed with biopsy-proven AMR. In dnDSA(+) cases, both C3d and C1q binding abilities were retrospectively assessed using both C1qScreen assay (One lambda, USA) and Lifecodes C3d assay (Immucor, Belgium). IgG DSAs were screened with LABScreen Single Antigen (One Lambda), and additionally tested with Lifecodes LSA Class I and Class II kits (Immucor) in dnDSA(+) sera.
Fifty-five (33.3%) patients developed dnDSAs (HLA class I, n=20; class II n=29, class I+II, n=6). AMRs and C4d deposition in allograft tissue were significantly associated with dnDSA(+) (P<0.001 and P<0.001). Of 55 dnDSA(+) patients, 17 (30.9%), 24 (43.6%) and 14 (25.5%) patients had C1q+/C3d-, Cq-/C3d+ and C1q+/C3d+, respectively. Complement binding DSAs had higher MFI values (mean ± SD) of one lambda IgG DSAs (C1q-/C3d-, 2784±1934; C1q+/C3d-, 3911±1556; C1q-/C3d+, 7020±5633; C1q+/C3d+, 11090±7281). In terms of Immucor IgG DSAs, the MFI values were 1930±2165 (C1q-/C3d-), 2597±2966 (C1q+/C3d-), 9040±7087 (C1q-/C3d+) and 11815±5933 (C1q+/C3d+). The C1q+ or C3d+ HLA class I dnDSA was associated with a higher rate of AMR development compared with C1q- or C3d- dnDSA (P=0.003, p=0.009, respectively). The C3d+ dnDSA was associated with C4d deposition in allograft tissue (P=0.05). In nonsensitized patients, the C1q binding ability of dnDSA was a better predictor of AMR than dnDSA (diagnostic odds ratio 24.9 vs. 16.4, respectively).
Our results suggest that detection of complement binding activity of dnDSA at the time of biopsy would be helpful for predicting AMR.
CITATION INFORMATION: Lee H, Han E, Choi A.-R, Park K, Ryu J, Chung B, Yang C, Oh E.-J. Complement Binding Activity (C3d, C1q) of De Novo Donor-Specific HLA Antibody Is Associated with Increased Risk of Antibody-Mediated Rejection in Non-Sensitized Kidney Transplant Recipients. Am J Transplant. 2017;17 (suppl 3).
To cite this abstract in AMA style:Lee H, Han E, Choi A-R, Park K, Ryu J, Chung B, Yang C, Oh E-J. Complement Binding Activity (C3d, C1q) of De Novo Donor-Specific HLA Antibody Is Associated with Increased Risk of Antibody-Mediated Rejection in Non-Sensitized Kidney Transplant Recipients. [abstract]. Am J Transplant. 2017; 17 (suppl 3). https://atcmeetingabstracts.com/abstract/complement-binding-activity-c3d-c1q-of-de-novo-donor-specific-hla-antibody-is-associated-with-increased-risk-of-antibody-mediated-rejection-in-non-sensitized-kidney-transplant-recipients/. Accessed October 24, 2020.
« Back to 2017 American Transplant Congress