Impact of Intravenous Immunoglobulins on Anti-HLA Immunization after Renal Allograft Nephrectomy
Nephrology-Transplantation, Henri Mondor, APHP, Créteil, France
Public Health, Henri Mondor, APHP, Créteil, France
Urology, Henri Mondor, APHP, Créteil, France
Histocompatibility, Saint Louis, APHP, Paris, France
Agence de la Biomédecine, Saint-Denis, France
Meeting: 2013 American Transplant Congress
Abstract number: 317
Introduction
Renal allograft nephrectomy is a major risk factor for anti-HLA alloimmunization and antibody-mediated rejection after retransplantation. No preventive strategy has been evaluated.
Methods
We retrospectively analyzed anti-HLA DSA and non-DSA, using Luminex technology, in 58 patients presented with renal allograft nephrectomy between 2005 and 2010. For each patient, anti-HLA antibodies were assessed at the time of nephrectomy, 3 and 12 months after. Twenty-one (36%) were treated with intravenous immunoglobulins (IVIg) (1.5g/kg).
Results
Renal allograft nephrectomy was performed for intolerance graft syndrome (IGS) more than 6 months after transplant in 17 (81%) treated patients (TT) and in 15 (41%) untreated (UT) (p=0.005). After 12 months, only calculated PRA (cPRA) increased significantly in UT (p=0.004) and not in TT (p=0.05) although non DSA and DSA alloimmunization remained comparable in both groups.
Patients without DSA at the time of nephrectomy (TT N=7; NT N=12) exhibited similar anti-HLA non-DSA characteristics in both groups. Five (71%) TT patients vs. 2 (16%) UT presented with IGS (p=0.04). After 3 and 12 months, class I and class II DSA and non-DSA were significantly higher in UT group compare to TT group. TT group only increased significantly number of class I non-DSA with MFI > 1000. After 3 months, increase of class I non-DSA median number (MFI > 1000) and of non-DSA MFI max were significantly lower in TT group (50% vs. 96% (p=0.04); 21% vs. 87% (p=0.02) respectively). At 12 months, cPRA was significantly higher in UT group compared to TT group (p=0.04).
Conclusion
IVIg at the time of nephrectomy is likely to decrease cPRA 12 months after allograft nephrectomy and could improve waiting time for retransplantation.
To cite this abstract in AMA style:
Leibler-Romand C, Matignon M, Roudot-Thoraval F, Salomon L, Charron D, Lang P, Jacquelinet C, Suberbielle C, Grimbert P. Impact of Intravenous Immunoglobulins on Anti-HLA Immunization after Renal Allograft Nephrectomy [abstract]. Am J Transplant. 2013; 13 (suppl 5). https://atcmeetingabstracts.com/abstract/impact-of-intravenous-immunoglobulins-on-anti-hla-immunization-after-renal-allograft-nephrectomy/. Accessed December 2, 2024.« Back to 2013 American Transplant Congress