Date: Sunday, April 30, 2017
Session Time: 2:30pm-4:00pm
Presentation Time: 3:06pm-3:18pm
Introduction: Successful kidney transplantation despite a positive crossmatch is well known after combined liver-kidney transplantation (CLKT). However, recently, concerns regarding the impact of preformed anti-HLA DSAs on both kidney and liver transplants have been raised. In this retrospective multicenter study, we aimed to investigate the incidence and consequences of preformed DSAs on liver and kidney allografts after CLKT.
Patients & method: 73 consecutive CLKT performed in the 3 participating centers were included in this study. All rejection episodes were reevaluated according to the last Banff classification for liver and kidney transplantations. Kidney and liver parameters were evaluated 1, 3, 6, 12, 24 and 60 months after transplantation, and at last follow-up.
Results: 9/73 (12%) patients were transplanted with preformed DSAs (4 with anti-HLA class I, 5 with anti-HLA class I and II DSAs). In 7 patients the crossmatch was positive. The patients' survivals at 1, 2, 3 and 5 years were 87%, 84%, 82%, and 78%, in patients without DSAs and 76% at 1, 2, 3, and 5 years (p=ns). The kidney grafts' survivals at 1, 2, 3 and 5 years were 94%, 90%, 90%, and 87% patients without DSAs and 85% at 1, 2, 3, and 5 years (p=ns). At 5 years post-CLKT, the proportion of patients having a GFR >30ml/min/1.73m[sup2] tended to be higher in patients without DSAs (67% vs. 45%, p=0.09). The incidence of kidney acute rejection was significantly higher in patients with preformed DSAs (3/9 vs. 3/64, p=0.02). Acute antibody mediated rejection was also higher in patients with DSAs (2/9 vs. 0/64, p= 0.01). The 5-years death-censored liver grafts' survival was similar in patients with or without preformed DSAs (100% vs. 91%. Liver acute rejection rate was also similar in patients with or without DSAs (20 vs.10%, p=ns). Only one episode of liver acute antibody mediated rejection was observed, in a patient transplanted with positive DSAs.
Conclusion: Although the incidence of kidney antibody mediated rejection was increased in patients with preformed DSAs, 5-years kidney and liver survivals were similar with or without preformed DSAs.
CITATION INFORMATION: Del Bello A, Bestard O, Visentin J, Congy-Jolivet N, Couzi L, Neau-Cransac M, Jambon F, Kamar N. Long-Term Liver and Kidney Survival Following Combined Liver-Kidney Transplantation, with or without Preformed Donor-Specific Antibodies. Am J Transplant. 2017;17 (suppl 3).
To cite this abstract in AMA style:Bello ADel, Bestard O, Visentin J, Congy-Jolivet N, Couzi L, Neau-Cransac M, Jambon F, Kamar N. Long-Term Liver and Kidney Survival Following Combined Liver-Kidney Transplantation, with or without Preformed Donor-Specific Antibodies. [abstract]. Am J Transplant. 2017; 17 (suppl 3). https://atcmeetingabstracts.com/abstract/long-term-liver-and-kidney-survival-following-combined-liver-kidney-transplantation-with-or-without-preformed-donor-specific-antibodies/. Accessed January 27, 2021.
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