Effect of Preformed Donor-Specific Antibodies in Intestine/Multivisceral Transplantation.
1Divison of Transplant and Hepatobiliary Surgery, Henry Ford Transplant Institute, Detroit, MI
2Transplant Immunology, Henry Ford Hospital, Detroit, MI
Meeting: 2017 American Transplant Congress
Abstract number: 464
Keywords: HLA antibodies, Intestinal transplantation, Multivisceral transplantation, Rejection
Session Information
Session Name: Concurrent Session: Small Bowel: All Topics
Session Type: Concurrent Session
Date: Tuesday, May 2, 2017
Session Time: 2:30pm-4:00pm
Presentation Time: 3:18pm-3:30pm
Location: E271b
Aim: To analyze the effect of preformed donor-specific antibodies (DSA) in intestine/multivisceral transplantation patients.
Methods: Retrospective review of preformed and de novo DSAs of all intestine/multivisceral transplant recipients was performed. The patients with de novo DSAs alone were excluded. Patients were categorized based on the absence (Group 1) and presence (Group 2) of preformed DSAs. Incidence of rejection and outcomes in terms of graft and patient survival were studied. Survival was analyzed using log rank test.
Results: Twenty three patients underwent 26 intestinal/multivisceral transplantation between August 2010 and July 2016. Seventeen (65.4%) isolated intestinal, 7 (26.9%) multivisceral and 2 (7.7%) modified multivisceral transplants were performed. Of these, 14 cases belonged to Group 1 and 9 to Group 2. Three cases were excluded due to de novo DSAs alone. Eight (34.8%) cases had positive crossmatches at transplant. Group 2 had significantly higher positive crossmatches (77.8%) compared to Group 1 (7.1%) (p=0.001). The average panel-reactive antibody (PRA) at transplant was 39.0%. PRA was also significantly higher in group 2 with 82.3% compared to group 1 with 11.1% (p<0.001). Ten (43.5%) grafts developed acute rejection with 4 having recurrent episodes. In the Group 1, 7 (50%) cases developed graft rejections with 2 developing recurrent episodes compared to 3 (33.3%) cases of rejection with 2 developing recurrence in Group 2. Rejection rates were similar in both groups (p=0.67). Patient and graft survival were also similar in both groups with median graft and patient survival of 983 days and 1376 days, respectively in group 1 and 1300 days and 1380 days, respectively in group 2 (p=1.0 and 0.38, respectively).
Conclusion: Preformed DSA do not seem to influence the occurrence of rejection or graft and patient survival. Larger studies are required to further exam the effect of preformed DSAs on intestinal/multivisceral grafts.
CITATION INFORMATION: Safwan M, Rizzari M, Collins K, Yoshida A, Skorupski S, Fagoaga O, Abouljoud M, Nagai S. Effect of Preformed Donor-Specific Antibodies in Intestine/Multivisceral Transplantation. Am J Transplant. 2017;17 (suppl 3).
To cite this abstract in AMA style:
Safwan M, Rizzari M, Collins K, Yoshida A, Skorupski S, Fagoaga O, Abouljoud M, Nagai S. Effect of Preformed Donor-Specific Antibodies in Intestine/Multivisceral Transplantation. [abstract]. Am J Transplant. 2017; 17 (suppl 3). https://atcmeetingabstracts.com/abstract/effect-of-preformed-donor-specific-antibodies-in-intestinemultivisceral-transplantation/. Accessed May 25, 2025.« Back to 2017 American Transplant Congress