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Prognostic Value of C3d Fixing Preformed Donor-Specific Antibody in Crossmatch-Positive Living Kidney Transplantation

K. Miyake1, M. Okumi1, Y. Kakuta1, K. Unagami2, M. Furusawa1, H. Ishida2, K. Tanabe1

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

Date: Sunday, June 2, 2019

Session Name: Concurrent Session: Kidney Acute Antibody Mediated Rejection

Session Time: 4:30pm-6:00pm

 Presentation Time: 5:18pm-5:30pm

Location: Ballroom B

Related Abstracts
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*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.

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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 April 16, 2021.

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