Presence of Preformed IgG3 DSA Identifies Patients at Higher Risk of Early Rejection in Liver Transplantation
UCLA, Los Angeles, CA
Baylor University Medical Center, Dallas, TX
Terasaki Foundation Laboratory, Los Angeles, CA
Meeting: 2013 American Transplant Congress
Abstract number: D1602
Aim: to examine the impact of preformed IgG3 donor-specific HLA antibodies (DSA) in early acute rejection after liver transplantation (LT).
Methods: We analyzed 1271 adult LT recipients from 2000 to 2009 with serum available for DSA determination (96% of patients transplanted). All sera were analyzed for DSA using LABScreen single antigen beads and MFI >5000 was considered positive. All DSA positive sera were analyzed for the presence of IgG3 subclass DSA and MFI >500 was considered positive.
Results: 65% of patients were male, 73% were Caucasian, with a median age of 52. The most common indications for LT were HCV in 31%, HCC in 24%, and autoimmune conditions in 14%. 44% of patients received induction therapy. Immunosuppression at 3 months included tacrolimus 65%, MMF 51%, sirolimus 15%, and steroids 54% of the time. Preformed DSA was observed in 14% of patients, and 32% of these were of the IgG3 subclass. Patients with preformed DSA had significantly higher rates of early acute rejection when compared to patients without preformed DSA (44% vs. 36%, p=0.004, figure 1). Patients with preformed DSA of the IgG3 subclass had a higher risk of early acute rejection compared to IgG3 negative patients (49% vs. 37%, p=0.05, figure 2).
Conclusion: Patients with preformed DSA show acute rejection rates 8% higher than in patients without preformed DSA. This difference is increased to 12% if the DSA is of the IgG3 subclass. IgG3 DSA may be a helpful additional biomarker to predict risk for acute rejection after liver transplantation.
BaÑuelos, N.: Employee, One Lambda, Inc. Terasaki, P.: Stockholder, One Lambda, Inc.
To cite this abstract in AMA style:
Kaneku H, O'Leary J, Bañuelos N, Jennings L, Susskind B, Klintmalm G, Terasaki P. Presence of Preformed IgG3 DSA Identifies Patients at Higher Risk of Early Rejection in Liver Transplantation [abstract]. Am J Transplant. 2013; 13 (suppl 5). https://atcmeetingabstracts.com/abstract/presence-of-preformed-igg3-dsa-identifies-patients-at-higher-risk-of-early-rejection-in-liver-transplantation/. Accessed December 2, 2024.« Back to 2013 American Transplant Congress