Prognostic Value of C3d Fixing Preformed Donor-Specific Antibody in Crossmatch-Positive Living Kidney Transplantation
1Urology, Tokyo Women's Medical University, Sinjuku, Japan, 2Organ Transplant Medicine, Tokyo Women's Medical University, Sinjuku, Japan
Meeting: 2019 American Transplant Congress
Abstract number: 114
Keywords: Antibodies, Kidney, Rejection
Session Information
Session Name: Concurrent Session: Kidney Acute Antibody Mediated Rejection
Session Type: Concurrent Session
Date: Sunday, June 2, 2019
Session Time: 4:30pm-6:00pm
Presentation Time: 5:18pm-5:30pm
Location: Ballroom B
*Purpose: The occurrence of acute antibody-mediated rejection (ABMR) was higher in flow cytometric crossmatch (FCXM)-positive patients despite desensitization, and complement binding ability of donor specific antibody (DSA) was important to predict ABMR. We herein investigated the correlations between 1) complement C3d-binding ability of preformed DSA and risk of ABMR, and 2) the efficacy of desensitization on C3d-fixing ability of DSA and risk of ABMR in the XM-positive patients.
*Methods: Twenty-one patients with preformed DSA-positive and XM-positive were included in this study. We retrospectively analyzed C3d-fixing ability of preformed DSA before desensitization and the influence of desensitization on C3d-fixing ability. Our desensitization protocol was Rituximab, plasmapheresis and high dose immunoglobulin from 30 days before transplantation.
*Results: Six patients had non-C3d-fixing DSA and 15 patients had C3d-fixing DSA. The presence of C3d-fixing DSA was significantly associated with re-transplantation (p=0.012). The presence of C3d-fixing DSA before desensitization was likely to be associated with the incidence of acute ABMR within 3 months post-transplantation (p=0.04) and chronic ABMR (p=0.03). However, the persistence of C3d-fixing DSA after desensitization was unlikely to be associated with ABMR (p=0.92).
*Conclusions: The presence of preformed C3d-fixing DSA caused significantly higher risk of ABMR in FCXM-positive patients. The measurement of C3d-fixing ability of DSA was recommended especially before desensitization to predict ABMR.
To cite this abstract in AMA style:
Miyake K, Okumi M, Kakuta Y, Unagami K, Furusawa M, Ishida H, Tanabe K. Prognostic Value of C3d Fixing Preformed Donor-Specific Antibody in Crossmatch-Positive Living Kidney Transplantation [abstract]. Am J Transplant. 2019; 19 (suppl 3). https://atcmeetingabstracts.com/abstract/prognostic-value-of-c3d-fixing-preformed-donor-specific-antibody-in-crossmatch-positive-living-kidney-transplantation/. Accessed July 3, 2025.« Back to 2019 American Transplant Congress