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|
|Peak PRA, mean||33||48||.305|
|ABDR HLA mismatches, mean||3.7||4.1||.315|
DSA class I/II/I+II, n
|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|
|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 March 6, 2021.
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