ATC Abstracts

American Transplant Congress abstracts

  • Home
  • Meetings Archive
    • 2020 American Transplant Congress
    • 2019 American Transplant Congress
    • 2018 American Transplant Congress
    • 2017 American Transplant Congress
    • 2016 American Transplant Congress
    • 2015 American Transplant Congress
    • 2013 American Transplant Congress
  • Keyword Index
  • Resources
    • 2016 Resources
      • 2016 Welcome Letter
      • ATC 2016 Program Planning Committees
      • ASTS Council 2015-2016
      • AST Board of Directors 2015-2016
    • 2015 Resources
      • 2015 Welcome Letter
      • ATC 2015 Program Planning Committees
      • ASTS Council 2014-2015
      • AST Board of Directors 2014-2015
      • 2015 Conference Schedule
  • Advanced Search

Donor-Specific Antibodies in a Single-Center Pediatric Kidney Transplant Population – Incidence and Risk Factors.

M. Bock,1 L. Starkey,1 C. Buchanan,2 E. Steinberg,2 A. Sikora,2 K. McKinnon,2 M. Wachs,2 J. Goebel.1

1Transplant Surgery, Children's Hospital Colorado, Aurora, CO
2Pediatric Nephrology, Children's Hospital Colorado, Aurora, CO.

Meeting: 2016 American Transplant Congress

Abstract number: D162

Keywords: HLA antibodies, Immunosuppression, Kidney transplantation, Pediatric

Session Information

Date: Tuesday, June 14, 2016

Session Name: Poster Session D: Kidney-Pediatrics

Session Time: 6:00pm-7:00pm

 Presentation Time: 6:00pm-7:00pm

Location: Halls C&D

Related Abstracts
  • Incidence and Risks Associated With Clostridium Difficile Infection in the Pediatric Solid Organ Transplantation Population: A Single-Center Retrospective Review
  • Living Donor Kidney Transplantation in the Pediatric Population: Risk Factors for Adverse Outcomes

In mid-2015, we implemented donor-specific antibody (DSA) monitoring in our pediatric kidney transplant recipient (pKTR) population as recommended (Transplantation 2013;95:19-). We now cross-sectionally analyzed our DSA data and, to explore potential predictors of DSA detection in clinically stable (i.e. with no recent fluctuations in T function) pKTRs, collected additional information from the time of DSA testing, including type of immunosuppression [IS, tacrolimus (TAC) vs. sirolimus (SIR)-based], antiproliferative agent dose, variation of the last 3 outpatient IS trough levels, proteinuria (PU, by random protein/creatinine ratio) and calculated glomerular filtration rate (GFR, by Schwartz formula).

A first DSA test was available from 61 pKTRs, 4 of which (all DSA+) had unstable T function (antibody-mediated rejection) and were excluded from further analysis. The characteristics of the other 57 pKTRs are shown

 Recipients (n)  57
     Female Gender  28
     Underlying Disease  
           CAKUT  23
           Glomerular  14
           Ischemia  4
           Other/Unknown  16
 Median Age (years)  
      at transplant  9.7
      at DSA testing  13.9
 Transplant (n)  57
      Living Donor  14
      Median HLA mismatches  3.4/6

. Initial IS was thymoglobulin induction for Ts from a deceased donor and steroids, TAC and mycophenolate (MMF). Steroids were generally not withdrawn, and TAC and MMF were either converted to SIR and azathioprine (AZA), respectively, for intolerance, or the MMF dose was reduced for apparent MMF-related problems.

The clinically stable pKTRs underwent DSA testing at a median of 2.2 years post-T, and 22/57 (40.4%) were DSA+ (1 class I only, 12 class II only, 9 both). 13/37 (35.1%) pKTRs on TAC and 10/20 (50%, n.s. vs. TAC, Chi-Square) on SIR were DSA+. DSA+ pKTRs were on significantly less MMF [497.5 (n: 13) vs. 704.9 (n:23) mg/sq.m./day, p:0.027 by T-test], had significantly more PU (1.3 vs. 0.44 mg/mg, p:0.025, T-test) and a trend towards worse GFR (63.4 vs. 75.9 ml/min, p:0.056, T-test). We found no significant differences in the number of HLA mismatches, IS trough level variation or other examined parameters.

We conclude that in stable pKTRs, reduced-dose MMF is a risk factor for DSA development and should thus be avoided.

CITATION INFORMATION: Bock M, Starkey L, Buchanan C, Steinberg E, Sikora A, McKinnon K, Wachs M, Goebel J. Donor-Specific Antibodies in a Single-Center Pediatric Kidney Transplant Population – Incidence and Risk Factors. Am J Transplant. 2016;16 (suppl 3).

  • Tweet
  • Email
  • Print

To cite this abstract in AMA style:

Bock M, Starkey L, Buchanan C, Steinberg E, Sikora A, McKinnon K, Wachs M, Goebel J. Donor-Specific Antibodies in a Single-Center Pediatric Kidney Transplant Population – Incidence and Risk Factors. [abstract]. Am J Transplant. 2016; 16 (suppl 3). https://atcmeetingabstracts.com/abstract/donor-specific-antibodies-in-a-single-center-pediatric-kidney-transplant-population-incidence-and-risk-factors/. Accessed March 8, 2021.

« Back to 2016 American Transplant Congress

Most Viewed Abstracts

  • This Week
  • This Month
  • All Time
  • Subtherapeutic Low Tacrolimus Trough Levels (≤3.5 Ng /ml) Are A Risk Factor For Acute Rejection And Creatinine Doubling.
  • Low GFR after Kidney Donation Is Not Chronic Kidney Disease
  • Penis Transplantation: First U.S. Experience.
  • Is There a Difference Between DCD and DBD Kidney Transplantation with Similar KDPI?
  • Live Related Kidney Transplant Experience in Abuja, Nigeria – First Eight Cases Ever.
  • Low GFR after Kidney Donation Is Not Chronic Kidney Disease
  • Subtherapeutic Low Tacrolimus Trough Levels (≤3.5 Ng /ml) Are A Risk Factor For Acute Rejection And Creatinine Doubling.
  • Penis Transplantation: First U.S. Experience.
  • Is There a Difference Between DCD and DBD Kidney Transplantation with Similar KDPI?
  • A Decade of Donor-Derived Disease: A Report of the OPTN Ad Hoc Disease Transmission Advisory Committee (DTAC).
  • Penis Transplantation: First U.S. Experience.
  • Is There a Difference Between DCD and DBD Kidney Transplantation with Similar KDPI?
  • Low GFR after Kidney Donation Is Not Chronic Kidney Disease
  • Evidence of a Clinically Significant Drug-Drug Interaction between Cannabidiol and Tacrolimus: A Case Report
  • Kidney Dialysis after Heart Transplantation: The Short and Long Term Outcomes

Visit Our Partner Sites

American Transplant Congress (ATC)

Visit the official site for the American Transplant Congress »

American Journal of Transplantation

The official publication for the American Society of Transplantation (AST) and the American Society of Transplant Surgeons (ASTS) »

American Society of Transplantation (AST)

An organization of more than 3000 professionals dedicated to advancing the field of transplantation. »

American Society of Transplant Surgeons (ASTS)

The society represents approximately 1,800 professionals dedicated to excellence in transplantation surgery. »

Copyright © 2013-2021 by American Society of Transplantation and the American Society of Transplant Surgeons. All rights reserved.

Privacy Policy

loading Cancel
Post was not sent - check your email addresses!
Email check failed, please try again
Sorry, your blog cannot share posts by email.
This site uses cookies: Find out more.