Kidney Transplantation with Strong Preformed Donor-Specific Antibodies: Impact of C1q-Binding Ability.
1Nephrology, CHP, Porto, Portugal
2CSTP, Porto, Portugal.
Meeting: 2016 American Transplant Congress
Abstract number: D24
Keywords: HLA antibodies, Kidney transplantation, Rejection, Renal failure
Session Information
Session Name: Poster Session D: Antibody Mediated Rejection: Session #2
Session Type: Poster Session
Date: Tuesday, June 14, 2016
Session Time: 6:00pm-7:00pm
Presentation Time: 6:00pm-7:00pm
Location: Halls C&D
HLA-incompatible kidney transplantation is associated with worse outcomes given the presence of donor-specific anti-HLA antibodies (DSA). Our aim was to investigate the association between preformed DSA C1q-binding ability and clinical outcomes.
Pretransplant sera of 61 patients (pts) known to possess DSA at transplant were retrospectively analyzed after EDTA-treatment by the C1q assay. In case of DSA>1, the cumulative strength was calculated (MFIsum). Cytotoxic crossmatch was negative in all cases. Median of DSA MFIsum was 11000. C1q-binding DSA were present in 12 pts, with 11 of them having a MFIsum >11000. Only the cohort of pts with these strong preformed DSA were considered (n=30) in this analysis.
Pts mean follow-up time was 5.5 years.
| Baseline characteristics | C1q- (n=19) | C1q+ (n=11) | P |
| Pts age, mean | 48 | 48 | .876 |
| Retransplants, n | 9 | 9 | .121 |
| Peak PRA, mean | 33 | 48 | .305 |
| ABDR HLA mismatches, mean | 3.7 | 4.1 | .315 |
|
DSA class I/II/I+II, n |
6/5/8 | 3/2/6 | .790 |
| DSA number, mean | 2.6 | 3.5 | .107 |
| ATG induction, n | 14 | 10 | .372 |
| Desensitized (IvIg+PP±Rtx), n | 3 | 3 | .641 |
| Clinical outcomes after transplantation | C1q- (n=19) | C1q+ (n=11) | P |
| Pts with graft biopsy>0, n | 13 | 10 | .215 |
| DGF, n | 8 | 5 | 1 |
| AMR, n | 9 | 8 | .259 |
| AMR C4d+, n | 5 | 8 | .023 |
| eGFR (ml/min) at 1 year, mean | 57 | 42 | .041 |
| Proteinuria at 1 year >0.5 g/g, n | 3 | 6 | .042 |
Censored kidney graft survival curves according with C1q-binding DSA status 
Censored kidney graft survival curves according with C1q-binding DSA and AMR status 
We confirmed the previous findings of a strong correlation between DSA strength and C1q-binding ability. Importantly, our results show a significant association between C1q-binding DSA, AMR C4d+ occurrence and shorter graft survival in pts transplanted with strong DSA.
CITATION INFORMATION: Malheiro J, Tafulo S, Santos S, Costa M, Martins L, Dias L, Henriques A. Kidney Transplantation with Strong Preformed Donor-Specific Antibodies: Impact of C1q-Binding Ability. Am J Transplant. 2016;16 (suppl 3).
To cite this abstract in AMA style:
Malheiro J, Tafulo S, Santos S, Costa M, Martins L, Dias L, Henriques A. Kidney Transplantation with Strong Preformed Donor-Specific Antibodies: Impact of C1q-Binding Ability. [abstract]. Am J Transplant. 2016; 16 (suppl 3). https://atcmeetingabstracts.com/abstract/kidney-transplantation-with-strong-preformed-donor-specific-antibodies-impact-of-c1q-binding-ability/. Accessed November 21, 2024.« Back to 2016 American Transplant Congress