Vessel trombosis represent the first cause of early graft loss (EGL)alter renal transplantation (RT). Our group recently described that preformed IgA antibodies to B2-Glycoprotein ( IgA.aB2GPI-ab) is associated with EGL.

The aim of the present study was to test if IgAaB2GPI-ab influence early outcomes, especially thrombosis after RT. with a high number of patients.. All transplant patients from cadaveric donors among 2000-2004 in our hospital were included and the presence of IgA.aB2GPI-ab in pre-transplant serum was retrospectively examined. Of the 584 renal transplant patients, 473 were included in the study (the remaining were excluded by combined transplantation and non-available pre-transplant serum).- One hundred and nine (31.5%) were positive for IgA.aB2GPI-ab (group I) and the remaining ones were negative 324 (68.5%) (group II).

Graft loss at six pot-transplant month was significant higher in group I (16% vs 4% p<0.001). The most frequent cause of graft loss was vessel thrombosis, significantly higher in group I ( 18/24 75%) vs 6/13, 46% p<0.001). Cox multivariate analysis demonstrated that the presence of IgA.aB2GPI-ab was an independent risk factor for graft loss ( HR 2.67, 1.3-5.4, p<0.01),, together with recipient age and delayed graft function.. The presence of IgAaB2GPI-ab was the only significant risk factor for vessel thrombosis (OR 7.82, 95% CI 2.82-18-75, p<0.001). Graft survival was significant lower in group I and patient survival was similar in both groups

In conclusion, these data strongly suggest that pre-transplant IgA-aB2GPI-ab have a detrimental effect on early graft outcomes, especially by vessel thrombosis

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