Pre-Formed AT1R Antibodies Are Associated with Rejection After Kidney Transplantation.
Nephrology, University of Washington, Seattle.
Meeting: 2016 American Transplant Congress
Abstract number: A147
Keywords: Alloantibodies, Kidney transplantation, Rejection
Session Information
Session Name: Poster Session A: Kidney: Acute Cellular Rejection
Date: Saturday, June 11, 2016
Session Time: 5:30pm-7:30pm
Presentation Time: 5:30pm-7:30pm
Location: Halls C&D
Antibody mediated injury is a significant contributor to rejection and allograft damage. Non-HLA antibodies have been increasingly recognized in association with graft dysfunction. Our goal was to define the prevalence of pre-formed antibodies against angiotensin II type-I receptor (AT1R) and to evaluate the association with renal allograft outcomes in a consecutive cohort of 151 renal transplant recipients. IgG antibodies against AT1R were measured by ELISA using stored samples obtained for HLA testing at the time of transplantation, starting with January 2005.
AT1R titers were categorized as negative if <10u/ml (44%), intermediate 10-17u/ml(38%) or positive if >17u/ml(18%). The presence of AT1R antibodies was inversely associated with age, dialysis status and diabetes.
|
|
AT1R<10 (n=66) |
AT1R 10-17 (n=57) |
AT1R>17 (n=28) |
p value |
|
Prevalence%(95%CI) |
43.7(35.7,51.7) |
37.8(29.9,45.6) |
18.5(12.3,24.8) |
|
|
Age (SD) |
53.9(11.9) |
47.6(15.2) |
46.6(14.7) |
0.007 |
|
Male Gender (%) |
41(62.1) |
37(64.9) |
16(57.1) |
0.79 |
|
White Race (%) |
47(71.2) |
41(71.9) |
17(60.7) |
0.58 |
|
Deceased Donor (%) |
54(81.8) |
34(59.7) |
20(71.4) |
0.025 |
|
Preemptive (%) |
6(9.1) |
14(24.6) |
3(10.7) |
0.045 |
|
Diabetes (%) |
22(33.3) |
8(14) |
5(17.9) |
0.031 |
We found a strong association between AT1R antibodies and cellular rejection in univariate and multivariate analyses.
|
|
OR (95%CI) |
p value |
|
Unadjusted |
|
|
|
AT1R 10-17 vs <10 |
3.71(1.11, 12. 38) |
0.033 |
|
AT1R >17 vs <10 |
10.03(2.83, 35.5) |
<0.001** |
|
Adjusted model* |
|
|
|
AT1R 10-17 vs <10 |
3.86(1.03, 14.47) |
0.045 |
|
AT1R >17 vs <10 |
9.99(2.6, 38.4) |
0.001 |
There was no association with antibody mediated rejection.
Pre-formed AT1R antibodies are prevalent and robustly associated with acute cellular rejection, independent of anti HLA antibodies. Prospective studies are needed to evaluate the mechanism and causative effect of these antibodies.
CITATION INFORMATION: Kim D, Warner P, Nelson K, Gimferrer I, Johnson C, Blosser C, Bakthavatsalam R, Leca N. Pre-Formed AT1R Antibodies Are Associated with Rejection After Kidney Transplantation. Am J Transplant. 2016;16 (suppl 3).
To cite this abstract in AMA style:
Kim D, Warner P, Nelson K, Gimferrer I, Johnson C, Blosser C, Bakthavatsalam R, Leca N. Pre-Formed AT1R Antibodies Are Associated with Rejection After Kidney Transplantation. [abstract]. Am J Transplant. 2016; 16 (suppl 3). https://atcmeetingabstracts.com/abstract/pre-formed-at1r-antibodies-are-associated-with-rejection-after-kidney-transplantation/. Accessed May 16, 2021.« Back to 2016 American Transplant Congress