Date: Sunday, April 30, 2017
Session Time: 6:00pm-7:00pm
Presentation Time: 6:00pm-7:00pm
Location: Hall D1
Donor-specific anti-HLA antibody (DSA)-mediated rejection (AMR) is a main cause of graft loss after kidney transplantation. Non-adherence is a risk factor for AMR and graft loss. Large intra-patient variability from calcineurin inhibitor intake (IPV) is associated with worse kidney-allograft survival. Adherence and IPV are significantly better in kidney-transplant patients given once daily tacrolimus (Advagraf®, ADV) compared to those receiving tacrolimus b.i.d (Prograf®, PRG). The aim of this retrospective study was to compare the incidences of DSAs in de novo kidney-transplant patients given PRG or ADV.
Between 1/2009 and 12/2013, all de novo non-HLA sensitized patients who had received a first isolated kidney transplantation in our center and that had received mycophenolic acid (MPA) and either PRG (n=168) or ADV (n=82), were included in the study. Anti-HLA antibodies were assessed before transplantation, and at 6, 12, 18, and 24 months post-transplantation, at each time patients presented with kidney-function impairment, assessed using the Luminex SA assay.
Significantly more patients that received PRG, compared to ADV, received an induction therapy, maintenance steroids and MPA at 1 and 2 years. At 2-years posttransplant, the incidences of DSAs were 3.57% under PRG and 1.2% under ADV (ns). Histological features of AMR with and without DSAs were 2.4% under PRG and 6% under ADV (ns). The incidence of T-cell mediated rejection was 8.3% under PRG and 17% under ADV (p=0.06). The patients' and graft-survival rates, IPV, and kidney function at 12 and 24 months, and infection rates were similar in both groups.
In conclusion, patients given tacrolimus and MPA had a similar low incidence of DSAs at 2 years post-transplantation, and no difference was observed between patients given Prograf or Advagraf.
CITATION INFORMATION: Kamar N, Hajj V, Ferrandiz I, Younes E, Esposito L, Hébral A, Del Bello A. Incidence of Donor-Specific Anti-HLA Antibodies in Non-HLA Sensitized Patients Given Tacrolimus Once or Twice Daily During the First Two Years Post-Transplantation. Am J Transplant. 2017;17 (suppl 3).
To cite this abstract in AMA style:Kamar N, Hajj V, Ferrandiz I, Younes E, Esposito L, Hébral A, Bello ADel. Incidence of Donor-Specific Anti-HLA Antibodies in Non-HLA Sensitized Patients Given Tacrolimus Once or Twice Daily During the First Two Years Post-Transplantation. [abstract]. Am J Transplant. 2017; 17 (suppl 3). https://atcmeetingabstracts.com/abstract/incidence-of-donor-specific-anti-hla-antibodies-in-non-hla-sensitized-patients-given-tacrolimus-once-or-twice-daily-during-the-first-two-years-post-transplantation/. Accessed November 23, 2020.
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