NK-Cell Subset Distribution, Renal Function and Biopsy Findings in Kidney Transplant Recipients With HLA Donor-Specific Antibodies

M. Crespo,¹ D. Redondo,¹ J. Gimeno,² J. Yelamos,³ A. Muntasell,³ A. Faura,¹ M. Pérez-Sáez,¹ M. López-Montañes,⁴ A. Torío,⁵ C. García,⁶ M. Mir,¹ J. Hernandez,⁶ M. López-Botet,^3,4 J. Pascual.¹

¹Nephrology Unit, Hospital del Mar, Barcelona, Spain
²Servicio de Anatomía Patológica, Hospital del Mar, Barcelona, Spain
³Servicio de Inmunología, Institut Mar d'Investigacions Mediques, Barcelona, Spain
⁴Universitat Pompeu Fabra, Barcelona, Spain
⁵Laboratori de Referencia de Catalunya, Barcelona, Spain
⁶Immunology Department, Hospital de Alicante, Alicante, Spain.

Meeting: 2015 American Transplant Congress

Abstract number: A114

Keywords: Alloantibodies, Biopsy, Glomerular filtration rate (GFR), Natural killer cells

Session Information

Session Name: Poster Session A: Kidney Antibody Mediated Rejection

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: Detection of post-transplant donor-specific anti-HLA antibodies(DSA) constitutes a risk factor for kidney transplant (KT) loss. NK-cell antibody-dependent cell mediated cytotoxicity(ADCC) has been proposed to contribute to microvascular damage associated to antibody-mediated rejection(ABMR). We assessed peripheral NK-cell subsets in KT recipients with circulating DSA and the potential relationship with clinical outcomes or histological changes.

Methods: Observational exploratory study of 38 patients with anti-HLA DSA. Data base collecting demographics and clinical data. Contemporaneous analysis of HLA antibodies (Luminex screening and single-antigen tests) and peripheral CD3-CD56+NK-cells immunophenotyping (NKG2A, NKG2C, KIR, ILT2, CD161) a median of 60 months post-KT.

Results: Correlation was found between NKG2A+ cells and serum creatinine (r2=0.28, p=0.03) and eGFR (r2=-0.32, p=0.052) in DSA patients, but not in patients with anti-HLA non-DSA or in patients without anti-HLA antibodies. A higher SCr and urinary protein to creatinine ratio (PCOR) was found in DSA patients with NKG2A+ ≥40% (n=30) vs in those with NKG2A+<40% (n=8) (1.82±0.83 vs 1.17±0.46 mg/dl, p=0.04 and 368±372 vs 209±124 mg/mg, p=0.057, respectively). No significant correlation was detected between NK profile and graft loss. Of 29/38 DSA patients with biopsies, 23 had antibody-mediated changes according to Banff/09 classification (Category 2), and showed significantly higher %CD3-CD56+NKG2A+ than 6 DSA patients without ABMR histological lesions (63.3% [IQR:45.4,72.4] vs 44.4% [IQR:33.9,51.6], p=0.03). We did not find correlation between NK-cell profile and C4d staining or chronic transplant glomerulopathy.

Conclusions: Our study shows that the percentage of circulating NKG2A cells in KT recipients with DSA correlate with graft function and histological damage, thus probably selecting a subgroup of patients with stronger histological injury or different mechanisms of graft damage.

To cite this abstract in AMA style:

Crespo M, Redondo D, Gimeno J, Yelamos J, Muntasell A, Faura A, Pérez-Sáez M, López-Montañes M, Torío A, García C, Mir M, Hernandez J, López-Botet M, Pascual J. NK-Cell Subset Distribution, Renal Function and Biopsy Findings in Kidney Transplant Recipients With HLA Donor-Specific Antibodies [abstract]. Am J Transplant. 2015; 15 (suppl 3). https://atcmeetingabstracts.com/abstract/nk-cell-subset-distribution-renal-function-and-biopsy-findings-in-kidney-transplant-recipients-with-hla-donor-specific-antibodies/. Accessed May 8, 2025.

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