Date: Tuesday, June 14, 2016
Session Time: 6:00pm-7:00pm
Presentation Time: 6:00pm-7:00pm
Location: Halls C&D
Introduction. Antibody-mediated rejection (ABMR) is the major cause of allograft failure. We studied the evolution and prognostic effect of pre-formed and de novo anti-HLA antibodies after renal transplantation (RT) using with percentage of virtual reactive antibodies.
Material and Methods. We studied 591 patients who underwent RT between January 2008 and December 2012, followed to June 2014 (median 40 months, interquartile range 26-58). The percentage of virtual reactive antibodies was calculated with the Eurotransplant program periodically before RT, at the time ofRT, at months 1, 3 and 6 post-RT, and thereafter annually.
Results. By general linear modeling, repeated measurement showed a progressive increase of anti-HLA antibodies (percent virtual reactive antibodies) in all patients (3.5±13.3 vs. 8.3±23.9; p<0.001) and in those with preformed antibodies (34.6±26.1 vs. 66.7±31.2; p<0.001). Of the 51 patients (8.6%) who formed de novo donor specific antibodies (DSA) (70.6% class II) 21 experienced ABMR, and 7 (33.4%) lost the graft. In the remaining 14, the DSA became negative after treatment in 7, in 3 the mean fluorescence intensity (MFI) increased and in 4 the MFI remained unchanged. C1q-fixing by de novo DSA was associated with a 6-fold risk of graft loss (OR 6.00, 95% CI 1.12-32.25; p=0.03), with a graft survival at six years of just 66.7% vs. 87.6% (p=0.001). Multivariate logistic regression analysis showed that risk factors for novo DSA were cellular rejection (OR 5.80, 95% CI 2.82-11.90; p<0.001), pre-RT antibodies (OR 12.34, 95% CI 5.24-28.50; p<0.001) and delayed graft function (OR 2.05, 95% CI 1.01-4.15; p=0.04).
Conclusion. Following RT there is expansion of formation of anti-HLA antibodies, with C1q-fixing de novo DSA having a worse prognosis.
CITATION INFORMATION: Ruiz-Esteban P, Gonzalez-Molina M, Caballero A, Torio A, Leon M, Palma E, Burgos D, Cabello M, Lopez V, Rodriguez M, Hernandez D. Expansion of Anti-HLA Antibodies After Renal Transplantation and Prognosis in Those Which Fix C1q. Am J Transplant. 2016;16 (suppl 3).
To cite this abstract in AMA style:Ruiz-Esteban P, Gonzalez-Molina M, Caballero A, Torio A, Leon M, Palma E, Burgos D, Cabello M, Lopez V, Rodriguez M, Hernandez D. Expansion of Anti-HLA Antibodies After Renal Transplantation and Prognosis in Those Which Fix C1q. [abstract]. Am J Transplant. 2016; 16 (suppl 3). https://atcmeetingabstracts.com/abstract/expansion-of-anti-hla-antibodies-after-renal-transplantation-and-prognosis-in-those-which-fix-c1q/. Accessed March 4, 2021.
« Back to 2016 American Transplant Congress