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

Factors Associated with Acute Rejections in Kidney Transplant Recipients: Time for HLA-DR Matching in Elderly Recipients?

D. Khadzhynov, F. Halleck, L. Lehner, M. Duerrr, A. Kleinsteuber, D. Schmidt, K. Budde, O. Staeck.

Nephrology, Charite Universitaetsmedizin, Berlin, Germany.

Meeting: 2016 American Transplant Congress

Abstract number: 47

Keywords: Age factors, Donors, HLA-DR antigens, marginal, Outcome

Session Information

Date: Sunday, June 12, 2016

Session Name: Concurrent Session: Kidney Transplantation: Outcomes, Matching and Marginal Donors

Session Time: 2:30pm-4:00pm

 Presentation Time: 3:42pm-3:54pm

Location: Ballroom B

Related Abstracts
  • HLA-DR Matching Improves Immunologic Outcomes in Elderly Kidney Transplant Recipients
  • Acute Rejections and Incidence of De Novo DSA Depend on Donor Factors and Deceased Donor Kidney Associated Risk Assessed by the Kidney Donor Profile Index (KDPI).

Background. Within the Eurotransplant Senior Allocation Program (ESP) HLA-matching is neglected,potentially causing inferior outcomes. There is a lack of data analysing the long-term immunologic outcomes in elderly kidney transplant recipients (KTR).

Methods. This retrospective study included 972 KTR between 2004 and 2014. Data analysis included patient and graft survival, biopsy proven rejections (T-cell mediated rejections (TCMR) and antibody mediated rejection (ABMR)) and the development of de-novo DSA. KTR were further categorized according to age in 728 younger (<65) and 244 elderly (≥65 years) KTR and furthermore according to HLA-DR matches.

Results.

Elderly KTR showed significantly shorter time on dialysis (44 vs. 61 months), shorter cold ischemia time (CIT) (9 vs 12 hours), more HLA mismatches (4 vs. 2) and a higher proportion of DGF (46% vs. 29%). In the subgroup of elderly KTR there was a higher incidence of de novo DSA (33% vs. 25%, p=0.034) and TCMR (39% vs. 27%, p<0.001) at 7 years post-transplant.A multivariate analysis adjusted for all relevant factors revealed donor age (HR 1.01; p=0.044), CIT (HR 1.02; p=0.064), delayed graft function (HR 2.88; p<0.001) and HLA-DR mismatches (HR 2.19; p<0.001) as independent predictors for TCMR. Older recipient age however was protective (HR of 0.99 per year, p=0.002).

Within the group of elderly KTR, an increasing number of HLA-DR mismatches was associated with a significant higher risk for TCMR (p=0.027) and development of de novo DSA (p=0.036), while there was no significant difference regarding ABMR (Fig 1a-d). Occurrence of TCMR or de-novo DSA in elderly KTR resulted in significantly poorer graft survival (p=0.010 and p=0.022 respectively) (Fig 1e-f).

Conclusions. HLA-DR mismatches are a strong independent risk factor for TCMR and the development of de-novo DSA in elderly KTR, both significantly worsening graft survival. Introduction of HLA-DR matching in ESP might significantly improve immunologic outcomes.

CITATION INFORMATION: Khadzhynov D, Halleck F, Lehner L, Duerrr M, Kleinsteuber A, Schmidt D, Budde K, Staeck O. Factors Associated with Acute Rejections in Kidney Transplant Recipients: Time for HLA-DR Matching in Elderly Recipients? Am J Transplant. 2016;16 (suppl 3).

  • Tweet
  • Email
  • Print

To cite this abstract in AMA style:

Khadzhynov D, Halleck F, Lehner L, Duerrr M, Kleinsteuber A, Schmidt D, Budde K, Staeck O. Factors Associated with Acute Rejections in Kidney Transplant Recipients: Time for HLA-DR Matching in Elderly Recipients? [abstract]. Am J Transplant. 2016; 16 (suppl 3). https://atcmeetingabstracts.com/abstract/factors-associated-with-acute-rejections-in-kidney-transplant-recipients-time-for-hla-dr-matching-in-elderly-recipients/. 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.