Presence of AT1R Antibody Pre-Transplant Does Not Correlate with Rejection in a Large Pediatric Kidney Transplant Cohort
1University Health Transplant Institute, San Antonio, TX, 2Pharmacy, University Health Transplant Institute, San Antonio, TX
Meeting: 2022 American Transplant Congress
Abstract number: 825
Keywords: Antibodies, Kidney transplantation, Pediatric
Topic: Clinical Science » Kidney » 43 - Kidney: Pediatrics
Session Information
Session Time: 5:30pm-7:00pm
Presentation Time: 5:30pm-7:00pm
Location: Hynes Halls C & D
*Purpose: Describe correlations between pre-transplant (PreTXP) presence of anti-angiotensin II receptor type 1 antibodies (AT1RAb) and post-transplant (PostTXP) outcomes in a pediatric kidney transplant (PKT) cohort.
*Methods: PKT patients (>18 years of age) transplanted consecutively between 2013 and 2020 were AT1RAb screened in immediate pre-transplant serum samples by commercial ELISA. Statistical associations between PreTXP AT1RAb detection levels and multiple PostTXP metrices were observed (Table 1). HLA-DSA identified by luminex single antigen bead identification assay and were positive at >1000 mean fluorescence intensity (MFI). Patients were excluded if PreTXP samples or PostTXP data points were unavailable. Univariate and multivariate statistical analysis were conducted in R (R Core Team, 2021).
*Results: 116 PKT patients met inclusion criteria and were majority Hispanic (60%). 73% of PKT had borderline and positive levels of PreTXP AT1RAb (31 negative <10 U/ml, 33 borderline 10-17 U/ml, 52 positive >17 U/ml). Most of PKT involved first-time recipients 97%(113 ), Basiliximab induction 72%(83), deceased donation 89%(103) and absence of pre-formed HLA-DSA 86%(100). Antibody-mediated rejection (AMR) within the first-year PostTXP occurred in 3%(3) of the cohort. Rejection at anytime PostTXP occurred in 61%(71) of PKT. Year 1 PostTXP de novo HLA-DSA were detected in 45%(52) of PKT. Patients with PreTXP AT1RAb did not have increased instance of PKT rejection (Figure 1). Similarly, no increase in indicators of poor graft outcome was observed (Table 1). Further, no correlation between presence of PreTXP AT1RAb >10 U/ml and development of de novo DSA was observed. Rejection and de novo DSA formation were not statistically influenced by race, induction, donor type or presence of pre-formed HLA-DSA.
*Conclusions: Contrary to recent studies of AT1RAb detection in PKT, detection of PreTXP AT1RAb did not correlate with rejection in this large cohort. This study brings into question the relevance of PreTXP AT1RAb screening for PKT and supports the need for mechanistic study of AT1RAb impacts on PKT.
To cite this abstract in AMA style:
Hitchman K, Shah PK, Fritze D, Hinojosa R, Ranch D. Presence of AT1R Antibody Pre-Transplant Does Not Correlate with Rejection in a Large Pediatric Kidney Transplant Cohort [abstract]. Am J Transplant. 2022; 22 (suppl 3). https://atcmeetingabstracts.com/abstract/presence-of-at1r-antibody-pre-transplant-does-not-correlate-with-rejection-in-a-large-pediatric-kidney-transplant-cohort/. Accessed May 9, 2025.« Back to 2022 American Transplant Congress