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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.

A. Colovai, M. Ajaimi, N. Hayde, L. Kamal, S. Chan, C. Savchik, J. Rocca, E. Akalin.

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).

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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 May 28, 2025.

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