Increased Late Graft Loss in Kidney Recipients With Serum Sickness Disease Following Anti-Thymocyte Globulin Induction: Relation With an Anti-Neu5Gc Response
1INSERM UMR 1064, ITUN, CHU de Nantes, Nantes University, Nantes, France
2Société
d'Accélération du Transfert de Technologies Ouest Valorisation, Rennes, France
3EA 4275 SPHERE, Biostatistics, Clinical Research and Pharmaco-Epidemiology, Nantes, France
4Transplant Center, Institute for Clinical and Experimental Medicine, Prague, Czech Republic
5Central European Institute of Technology, Brno University of Technology, Brno, Czech Republic
6IECM, EA4644 University/ONIRIS USC1383 INRA, ONIRIS, Nantes, France
7EFS Pays de la Loire, Nantes, France.
Meeting: 2015 American Transplant Congress
Abstract number: B106
Keywords: Antilymphocyte antibodies, Graft failure, Kidney transplantation, Risk factors
Session Information
Session Name: Poster Session B: Kidney Complications: Late Graft Failure
Session Type: Poster Session
Date: Sunday, May 3, 2015
Session Time: 5:30pm-6:30pm
Presentation Time: 5:30pm-6:30pm
Location: Exhibit Hall E
Anti-thymocyte globulins (ATG) are rabbit IgGs against human T cells widely used as induction treatment of kidney recipients. ATG can induce immune-complex diseases including Serum Sickness Diseases (SSD). Rabbit and human IgGs differ in the expression of the sialic acid Neu5Gc, and humans exhibit preexisting and produce elicited anti-Neu5Gc antibodies. We assessed here the role of SSD on long-term allograft outcome in a cohort of 889 first kidney graft recipients with ATG induction, grafted between 1985 and 1998 (n=86 with overt SSD and n=803 without SSD), and analyzed the immunization status of a subgroup of this population against some xeno-antigens. We show that SSD is associated with the risk of graft failure (death-censored, HR=1.72, p=0.022). Total anti-ATG, anti-Gal and anti-Neu5Gc IgG levels were analyzed in a case-control subgroup constituted of 14 SSD+ versus 42 SSD- patients matched for 5 variables (recipients age, date of graft, PRA class I/II positivity, HLA mismatches). No significant differences were found in preexisting antibodies of any type. SSD+ patients exhibited elevated titers of anti-ATG (p=0.001) and anti-Neu5Gc (p=0.054) between pre-graft and late post-graft samples. Anti-Neu5Gc IgGs were increased in late post-graft sera of SSD+ patients when compared to SSD- patients (p=0.020). Anti-Gal antibodies were not informative. Finally, late graft survival was associated with high anti-Neu5Gc IgG levels in late post-graft samples, independently of SSD status (p=0.025). In conclusion, we demonstrated that ATG-induced SSD is an independent risk factor of graft failure, and suggested that anti-Neu5Gc antibodies could have a role in allograft outcome following SSD.
To cite this abstract in AMA style:
Salama A, Couvrat-Desvergnes G, Lorent M, Evanno G, Berre LLe, Hruba P, Vesely P, Guerif P, Nicot A, Bach J-M, Foucher Y, Brouard S, Castagnet S, Viklicky O, Giral M, Harb J, Jean-Paul S. Increased Late Graft Loss in Kidney Recipients With Serum Sickness Disease Following Anti-Thymocyte Globulin Induction: Relation With an Anti-Neu5Gc Response [abstract]. Am J Transplant. 2015; 15 (suppl 3). https://atcmeetingabstracts.com/abstract/increased-late-graft-loss-in-kidney-recipients-with-serum-sickness-disease-following-anti-thymocyte-globulin-induction-relation-with-an-anti-neu5gc-response/. Accessed December 2, 2024.« Back to 2015 American Transplant Congress