Session Time: 6:00pm-7:00pm
Presentation Time: 6:00pm-7:00pm
Location: Halls C&D
Introduction: Antibody-mediated rejection (ABMR) is a concern in highly sensitized (HS) patients (pts) receiving renal transplant (tx). We have previously published that a donor specific antibody (DSA) relative intensity score (RIS) of > 17 at time of tx predicted ABMR in HS adults. Here we analyzed risk factors in HS pediatric pts.
Methods: 16 HS pts underwent renal tx from 1/2009 to 10/2014. 15/16 pts received a previous tx. All pts underwent desensitization with IVIg/Rituximab. RIS scores at the time of tx were calculated for each pt (Figure 1). Risk factors for ABMR were examined in 2 groups: ABMR+ (n=7) and ABMR- (n=9) .
Results: Pt characteristics were similar and pt survival was 100%. 2 ABMR+ pts suffered graft loss, one from rejection 16 months post-tx and the other from recurrent FSGS. ABMR+ pts had higher class I and II %PRA, and higher T and B-cell flow cytometric crossmatches at the time of tx, although not statistically significant. However, ABMR+ pts had a significantly higher RIS, p=0.032.
Conclusion: DSA-RIS was the most important predictor of ABMR+ in HS patients and should be considered in both allocation strategy and post-tx monitoring for ABMR.
|Characteristics||ABMR (n=7)||No ABMR (n=9)||P-value|
|Age, yr, Mean ± SD||21.0 ± 6.9||18.7 ± 3.9||0.42|
|Deceased donor||7||8||> 0.99|
|Sensitizing Events||> 0.99|
|Panel Reactive Antibody (PRA) % at tx|
|Class I||73.1 ± 19.1||49.1 ± 28.3||0.075|
|Class II||63.7 ± 29.8||61.0 ± 23.8||0.84|
|T-cell FCMX (Mean Channel Shift) at Tx- Pronase Treated||82.5 ± 73.4||61.6±59.9||0.57|
|B-cell FCMX (Mean Channel Shift) at Tx- Pronase Treated||251.2 ± 136.8||181.2 ± 107.0||0.37|
|DSA RIS at transplant|
|Class I only||7.0 ± 5.0||2.4 ± 2.9||0.043|
|Class II only||5.1 ± 7.0||0.9 ± 1.8||0.16|
|Both class I and class II||12.1 ± 9.3||3.3 ± 2.6||0.032|
CITATION INFORMATION: Kim I, Choi J, Vo A, Louie S, Mirocha J, Jordan S, Kamil E, Puliyanda D. Factors Predicting Risk for Antibody-Mediated Rejection in Highly Sensitized Pediatric Renal Transplants. Am J Transplant. 2016;16 (suppl 3).
To cite this abstract in AMA style:Kim I, Choi J, Vo A, Louie S, Mirocha J, Jordan S, Kamil E, Puliyanda D. Factors Predicting Risk for Antibody-Mediated Rejection in Highly Sensitized Pediatric Renal Transplants. [abstract]. Am J Transplant. 2016; 16 (suppl 3). https://atcmeetingabstracts.com/abstract/factors-predicting-risk-for-antibody-mediated-rejection-in-highly-sensitized-pediatric-renal-transplants/. Accessed September 22, 2019.
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