Introduction: Although it is well known that allograft nephrectomy (Nx) is followed by the development of donor-specific antibodies (DSAs) even after a short transplant period, there are few reported large studies demonstrating the timing of the development of DSA formation in previously unsensitised patients and no studies so far have compared the effect on allonsensitisation of Nx performed at different times after graft failure.

Methods: 63 patients were studied and assigned to three groups according to the time of the Nx: Group 1 within 24hrs (n=13); Group 2 1-30 days (n=27) and Group 3 >30days (n=23) from transplant failure. None of the patients had detectable DSAs at the time of kidney failure, or had a previous kidney transplant. Patients were screened for class I and class II HLA at the time of Nx and after 3, 6, 12 and 24 months using the single antigen Luminex assay. A mean fluorescence intensity value >1,000 was considered positive.

Results: the figure shows a rising prevalence of DSA positive patients with time in all groups. Surprisingly, Group 1 showed a higher rate of patients developing both class I and II DSAs at 6 months (p=0.03). All 4/13 patients in this group who received monoclonal antibody induction developed DSAs.

Discussion and Conclusions: even a brief exposure to the allograft can lead to the early production of DSAs and persistent sensitisation despite monoclonal antibody induction.This group of patients require further investigation and development of strategies to prevent sensitisation, particularly if they are suitable for retransplantation.

CITATION INFORMATION: Lucisano G, Brookes P, Santos-Nunez E, Firmin N, Gunby N, Hassan S, Gueret-Wardle A, Willicombe M, Taube D. Significant Allosensitisation Despite Early, within 24 Hour, Graft Nephrectomy. Am J Transplant. 2017;17 (suppl 3).

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