Date: Monday, June 3, 2019
Session Time: 2:30pm-4:00pm
Presentation Time: 3:06pm-3:18pm
Location: Veterans Auditorium
*Purpose: Development of donor specific anti-HLA (DSA) although is a known risk factor for Chronic immune injury (CII), it is undetectable in many patients with CII, suggesting that immune response to non-HLA antigens may contribute to rejection. Previous reports have described antibody-mediated damage and poor allograft survival caused by immune response to several kidney self-antigens (SAgs) Collagen IV (Col-IV), Perlecan, and Fibronectin (FN)). The aim of this study was to determine if humoral immune responses to SAgs correlates with progression of CII changes at 1 year or 2 years (ci>1, cg>0).
*Methods: Patients who received a kidney transplantation at our institution over a 3 year period and had 1 or 2 year biopsies with ci>1, cg>0 were included in this study. We matched all cases to 2 controls, on recipient age, race, donor age, Living or Deceased and CV>0 on 4 month biopsy (figure 1.). Sera were obtained at 0, 4, 12, and 24 months and retrospectively analyzed for the presence of antibodies to SAgs using ELISA. The presence of antibodies to SAgs were compared at 0, 4, 12, and 24 months using conditional logistic regression.
*Results: We identified a cohort of 214 kidney transplant recipients. Of these, we identified 33 cases (mean age: 52.4 years, mean KDPI: 66.5, Alemtuzumab induction: 58%, pretransplant DSA with >2000 MFI: 12.1%) and matched 66 controls. Logistical regression showed an odds ratio of 1 with the confidence interval crossing 1 for presence of response to SAgs at all the time points.
*Conclusions: In conclusion, in this preliminary study, humoral immune responses to either SAgs alone or in combination with DSA was not associated with progression of CII changes at 1 and 2 years after kidney transplantation.
To cite this abstract in AMA style:Nair SSukumaran, Ravichandran R, Heilman R, Jaramillo A, Ramon D, Buras M, Kaplan B, Mohanakumar T. Humoral Immune Responses to Kidney Associated Non-HLA Antigens is Not Associated with Progression to Chronic Immune Injury in Kidney Transplant Recipients [abstract]. Am J Transplant. 2019; 19 (suppl 3). https://atcmeetingabstracts.com/abstract/humoral-immune-responses-to-kidney-associated-non-hla-antigens-is-not-associated-with-progression-to-chronic-immune-injury-in-kidney-transplant-recipients/. Accessed November 29, 2020.
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