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Pre-Formed AT1R Antibodies Are Associated with Rejection After Kidney Transplantation.

D. Kim, P. Warner, K. Nelson, I. Gimferrer, C. Johnson, C. Blosser, R. Bakthavatsalam, N. Leca.

Nephrology, University of Washington, Seattle.

Meeting: 2016 American Transplant Congress

Abstract number: A147

Keywords: Alloantibodies, Kidney transplantation, Rejection

Session Information

Date: Saturday, June 11, 2016

Session Name: Poster Session A: Kidney: Acute Cellular Rejection

Session Time: 5:30pm-7:30pm

 Presentation Time: 5:30pm-7:30pm

Location: Halls C&D

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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).

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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 January 25, 2021.

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