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|
|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|
Class I, %
Class II, %
Class I and II, %
|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 December 9, 2019.
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