Natural Antibodies Are Associated With Rejection And Long-term Renal Allograft Loss In A Multi-center International Cohort

S. B. See¹, X. Yang², C. Burger³, B. Lamarthée⁴, R. Snanoudj⁵, R. Shihab¹, D. S. Tsapepas⁶, P. Roy¹, S. Larivière-Beaudoin⁷, K. Hamelin⁷, A. Mendoza Rojas⁸, N. M. van Besouw⁸, A. Bartosic⁹, N. Daniel⁹, E. R. Vasilescu¹⁰, S. Mohan¹¹, D. Cohen¹¹, L. Ratner¹¹, C. C. Baan⁸, J. S. Bromberg⁹, H. Cardinal⁷, D. Anglicheau³, Y. Sun², E. Zorn¹

¹CCTI, Columbia University Irving Medical Center, New York, NY, ²Biostatistics, Columbia University Irving Medical Center, New York, NY, ³Necker Hospital, Paris, France, ⁴Necker-Enfants Malades Institute, Paris, France, ⁵Bicêtre Hospital, Paris, France, ⁶Surgery, Columbia University Irving Medical Center, New York, NY, ⁷CHUM, Montreal, QC, Canada, ⁸Erasmus MC, Rotterdam, Netherlands, ⁹Surgery, University of Maryland School of Medicine, Baltimore, MD, ¹⁰Pathology and Cell Biology, Columbia University Irving Medical Center, New York, NY, ¹¹Medicine, Columbia University Irving Medical Center, New York, NY

Meeting: 2022 American Transplant Congress

Abstract number: 1226

Keywords: Antibodies, Graft failure, Kidney transplantation, Rejection

Topic: Basic Science » Basic Science » 04 - B-cell / Antibody /Autoimmunity

Session Information

Session Name: B-cell / Antibody /Autoimmunity

Session Type: Poster Abstract

Date: Monday, June 6, 2022

Session Time: 7:00pm-8:00pm

Presentation Time: 7:00pm-8:00pm

Location: Hynes Halls C & D

*Purpose: Potentially harmful non-donor-specific human leukocyte antigen antibodies have been identified in renal transplantation, including natural IgG antibodies (Nabs) reactive to varied antigenic structures.

*Methods: In this retrospective, multi-center study, we assessed Nabs by reactivity to apoptotic cells in sera collected from 1061 kidney transplant recipients across five centers to determine their association with graft outcomes.

*Results: Elevated pre-transplant Nabs were associated with graft loss (hazard ratio (HR) 2.71, 95% confidence interval (CI) 1.15-6.39, P=0.0232), the composite endpoint of graft loss or severe graft dysfunction (HR 2.40, CI 1.13-5.10 P=0.0232) and cellular rejection (odds ratio (OR) 1.77, CI 1.07-3.02, P=0.0310). High pre-transplant Nabs together with donor-specific antibodies (DSA) increased the risk of composite outcomes (HR 6.31, CI 1.81-22.0, P=0.0039). In patients with high pre-transplant Nabs, the subsequent development of post-transplant Nabs was associated with both cellular (OR 3.64, CI 1.61-8.36, p=0.0021) and mixed rejection (OR 3.10, CI 1.02-9.75, p=0.0473). Lastly, elevated pre- and post-transplant Nabs combined with DSA increased the risk of composite outcomes (HR 3.97, CI 1.51-10.43, P=0.0052) and cellular rejection (OR 7.28, CI 2.16 -25.96, P=0.0016).

*Conclusions: The presence of pre- and post-transplant Nabs, together with DSA, contribute to increased risk of poor graft outcomes and rejection following renal transplantation.

To cite this abstract in AMA style:

See SB, Yang X, Burger C, Lamarthée B, Snanoudj R, Shihab R, Tsapepas DS, Roy P, Larivière-Beaudoin S, Hamelin K, Rojas AMendoza, Besouw NMvan, Bartosic A, Daniel N, Vasilescu ER, Mohan S, Cohen D, Ratner L, Baan CC, Bromberg JS, Cardinal H, Anglicheau D, Sun Y, Zorn E. Natural Antibodies Are Associated With Rejection And Long-term Renal Allograft Loss In A Multi-center International Cohort [abstract]. Am J Transplant. 2022; 22 (suppl 3). https://atcmeetingabstracts.com/abstract/natural-antibodies-are-associated-with-rejection-and-long-term-renal-allograft-loss-in-a-multi-center-international-cohort/. Accessed May 30, 2025.

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