Date: Tuesday, May 5, 2015
Session Time: 2:15pm-3:45pm
Presentation Time: 2:51pm-3:03pm
Location: Room 118-AB
Background: Contradictory conclusions have emerged from clinical trials when testing the predictive value of C1q-binding donor-specific HLA-antibodies (HLA-DSA). The aim of this study was to investigate the association between C1q-binding ability of HLA-DSA and the clinical outcome (i.e. antibody-mediated rejection (AMR) and long-term allograft survival).
Methods: Pretransplant sera of 64 patients known to possess preformed HLA-DSA were retrospectively analyzed by the standard and anti-globulin (AHG) enhanced C1q assay.
Results: The cumulative incidence of clinical/subclinical AMR within 6 months posttransplant was equal in recipients with and without C1q-binding HLA-DSA when using the standard C1q and the AHG C1q assay with the cut-offs MFI 300, 500, and 1000 for positivity (p=0.62, p=0.47, p=0.80 and p=0.58, p=0.40, p=0.42, respectively). The prevalence of subclinical AMR at 3 and 6 months posttransplant was also not different between the recipients with and without C1q-binding HLA-DSA: p>0.55, p>0.35, and p>0.35 for the standard C1q assay; p>0.20, p>0.20, and p>0.10 for the AHG C1q assay with the cut-offs MFI 300, 500, and 1000. At a median of 8 years posttransplant, allograft survival was equal in patients with/without C1q-binding HLA-DSA (p>]0.57 for the standard and p>]0.09 for the AHG enhanced C1q assay). The MFI was a strong and independent factor for C1q-binding in both C1q assays (OR>8.25 for standard and >4.33 for AHG enhanced C1q assay; p<0.0001).
Conclusion:Pretransplant C1q-binding HLA-DSA either detected by the standard or the AHG enhanced C1q assay – were not predictive for any clinical outcome. The MFI of HLA-DSA was strongly influencing C1q-binding.
To cite this abstract in AMA style:Amico P, Hönger G, Hopfer H, Liwski R. The C1q-Binding Assays and Clinical Outcomes in Kidney Transplantation [abstract]. Am J Transplant. 2015; 15 (suppl 3). https://atcmeetingabstracts.com/abstract/the-c1q-binding-assays-and-clinical-outcomes-in-kidney-transplantation/. Accessed June 16, 2019.
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