Pre-Transplant Non-Cytotoxic Donor Specific HLA Antibodies Do Not Increase the Risk of Graft Dysfunction in Kidney Transplant Recipients with Thymoglobulin and IVIG Induction.
Surgery, Montefiore Medical Center, Bronx, NY
Meeting: 2017 American Transplant Congress
Abstract number: B66
Keywords: Antibodies, Graft function, Histocompatibility antigens, Kidney transplantation
Session Information
Session Name: Poster Session B: Antibody Mediated Rejection in Kidney Transplant Recipients II
Session Type: Poster Session
Date: Sunday, April 30, 2017
Session Time: 6:00pm-7:00pm
Presentation Time: 6:00pm-7:00pm
Location: Hall D1
The aim of this study was to evaluate the impact of pre-formed donor specific HLA antibodies (DSA) in a large population of kidney transplant (tx) recipients.
The study population included 681 patients transplanted at our center from Jan 1st 2009 to Dec 31st 2014. Serum anti-HLA antibodies were tested using Single Antigen Beads (One Lambda/ThermoFisher). MFI cutoff values of 5,000-10,000 were used for reporting unacceptable antigens. Patients with acceptable DSA were considered for tx based on a negative complement-dependent-cytotoxicity crossmatch. Induction therapy consisted in Thymoglobulin/Simulect in patients without DSA and Thymoglobulin and IVIG in patients with DSA.
Out of 108 (16%) patients with pre-tx DSA, 67 patients lost DSA and 41 showed persisted DSA at one year post-tx. Patient characteristics and outcomes are presented in Table 1.
| Patient Characteristics and Outcomes | No pre-tx DSA (N=573) | Pre-tx DSA, lost post-tx (N=67) | Pre-tx DSA, persistent (N=41) | p-value |
| Age, mean | 53 | 54 | 51 | 0.198 |
| Gender, % female | 38 | 57 | 62 | <0.001 |
| Race, % African Americans | 40 | 45 | 51 | 0.286 |
| Transplant type, % live donor | 23 | 22 | 17 | 0.628 |
| Peak cPRA cl I, median | 0 | 30 | 59 | <0.001 |
| Peak cPRA cl II, median | 0 | 29 | 50 | <0.001 |
| DSA type
Class I, % Class II, % Class I and II, % |
64
30 6 |
44
37 19 |
<0.001 | |
| MFI, mean | 2325 | 4608 | <0.001 | |
| Acute rejection, % | 11 | 10 | 12 | 0.341 |
| Chronic rejection/Transplant glomerulopathy, % | 10 | 8 | 2 | 0.317 |
| Last creatinine, mean (g/dl) | 1.5 | 1.8 | 1.5 | 0.447 |
| Urine creatinine/protein ratio at 1yr, median (g/g) | 0.21 | 0.23 | 0.19 | 0.168 |
| Urine creatinine/protein ratio at 3yrs, median (g/g) | 0.22 | 0.38 | 0.22 | 0.253 |
There was no difference between incidence of acute antibody mediated or cellular rejection; chronic rejection/tx glomerulopathy; creatinine; urine creatinine/protein ratio; graft and patient survival between patient groups.
Our results indicate that low level pre-tx DSA do not increase the risk of graft dysfunction or loss in kidney transplant recipients who receive thymoglobulin/IVIG induction therapy.
CITATION INFORMATION: Colovai A, Ajaimi M, Hayde N, Kamal L, Chan S, Savchik C, Rocca J, Akalin E. Pre-Transplant Non-Cytotoxic Donor Specific HLA Antibodies Do Not Increase the Risk of Graft Dysfunction in Kidney Transplant Recipients with Thymoglobulin and IVIG Induction. Am J Transplant. 2017;17 (suppl 3).
To cite this abstract in AMA style:
Colovai A, Ajaimi M, Hayde N, Kamal L, Chan S, Savchik C, Rocca J, Akalin E. Pre-Transplant Non-Cytotoxic Donor Specific HLA Antibodies Do Not Increase the Risk of Graft Dysfunction in Kidney Transplant Recipients with Thymoglobulin and IVIG Induction. [abstract]. Am J Transplant. 2017; 17 (suppl 3). https://atcmeetingabstracts.com/abstract/pre-transplant-non-cytotoxic-donor-specific-hla-antibodies-do-not-increase-the-risk-of-graft-dysfunction-in-kidney-transplant-recipients-with-thymoglobulin-and-ivig-induction/. Accessed November 21, 2024.« Back to 2017 American Transplant Congress