Maintaining Immunosuppressive Treatment After Early Allograft Nephrectomy Does Not Reduce the Risk of Anti-HLA Allo-Sensitization
1Nephrology, Dialysis and Organ Transplantation, CHU Rangueil, Toulouse, France
2Université
Paul Sabatier, Faculté
de Médecine, Toulouse, France
3Molecular Immunogenetics Laboratory, EA 3034, Faculté
de Médecine Purpan, IFR150, Toulouse, France
4Department of Immunology, CHU Rangueil, Toulouse, France
5Department of Pathology, CHU Rangueil, Toulouse, France
6Nephrology, Clinique Saint-Exupery, Toulouse, France
7INSERM U1043, IFR–BMT, CHU Purpan, Toulouse, France.
Meeting: 2015 American Transplant Congress
Abstract number: A48
Keywords: Alloantibodies, Graft failure, Kidney transplantation, Nephrectomy
Session Information
Session Name: Poster Session A: Delayed Function/Acute Injury/Outcomes/Glomerulonephritis
Session Type: Poster Session
Date: Saturday, May 2, 2015
Session Time: 5:30pm-7:30pm
Presentation Time: 5:30pm-7:30pm
Location: Exhibit Hall E
Background
Anti-HLA immunization is greatly increased after early kidney-allograft failure, even if the graft is removed within a few hours post-transplantation. The aim of our study was to compare the incidence of anti-HLA antibodies in patients who were continued immunosuppression for three months after early allograft failure and a nephrectomy (within <1 week) and those who were weaned off immunosuppression.
Methods
Group 1: between 2007 and 2012, 21 patients who had early graft loss were weaned off immunosuppression immediately. Group 2: between 2012 and 2013, 11 patients with allograft nephrectomy were given tacrolimus (target trough level 4–6 ng/mL), mycophenolate mofetil (1 g/d), and steroids for three months. The median time between transplantation and nephrectomy was similar in both groups (1 [0–2] and 1 [0–5] days).
Results
The rate of HLA sensitization was similar in both groups at transplantation and none had pre-formed donor-specific antibodies (DSA). At month 12, the incidences of DSA and non-DSA anti-HLA antibodies were 82% and 82% in the immunosuppression group, and 74% and 78% in patients who received no immunosuppression. More complications were observed in patients that received immunosuppression.
Conclusion
Prolonged immunosuppression after early graft failure does not prevent anti-HLA immunization and it also increases the risk of complications.
To cite this abstract in AMA style:
Bello ADel, Congy-Jolivet N, Cardeau-Desangles I, Guilbeau-Frugier C, Pambrun E, Dörr G, Milioto O, Esposito L, Rostaing L, Kamar N. Maintaining Immunosuppressive Treatment After Early Allograft Nephrectomy Does Not Reduce the Risk of Anti-HLA Allo-Sensitization [abstract]. Am J Transplant. 2015; 15 (suppl 3). https://atcmeetingabstracts.com/abstract/maintaining-immunosuppressive-treatment-after-early-allograft-nephrectomy-does-not-reduce-the-risk-of-anti-hla-allo-sensitization/. Accessed November 21, 2024.« Back to 2015 American Transplant Congress