Preformed donor-specific antibodies and risk of antibody-mediated rejection in repeat renal transplantation

Demetra S. Tsapepas, Rodica Vasilescu, Bekir Tanriover, Yael Coppleson, Yelena Rekhtman, Mark A. Hardy, Geoffrey Dube, R. John Crew, Lloyd E. Ratner, David J. Cohen, Sumit Mohan

Research output: Contribution to journalArticle

16 Citations (Scopus)

Abstract

BACKGROUND: Allograft outcomes in patients undergoing repeat renal transplantation are inferior compared to first-time transplant recipient outcomes. Donor-specific antibodies detected by solid-phase assays (DSA-SPA) may contribute to the worse prognosis. The influence of DSA-SPA on repeat renal transplantation outcomes has not been previously studied in detail. DESIGN: This study reports the findings in 174 patients who underwent repeat renal transplantation between years 2007 and 2012. These included 62 patients with preformed DSA-SPA detected by Luminex at the time of transplantation. Patients received standard and consistent immunosuppression and were monitored closely for evidence of rejection. Recipients who underwent desensitization were excluded from this analysis. Endpoints included development of biopsy-proven acute rejection and analysis of graft survival and function. RESULTS: Patients in the DSA-SPA-positive and DSA-SPA-negative groups received similar immunosuppression, and a similar proportion of recipients had a peak panel reactive antibody greater than 20%; the two groups differed with respect to human leukocyte antigen mismatches (4.7±1.1 vs. 4.1±1.7, P=0.024). Recipients with preformed DSA-SPA had higher rejection rates (54.8% vs. 34.8%, P=0.01), including higher rates of antibody-mediated rejection (AMR) (32.3% vs. 7.1%, P

Original languageEnglish (US)
Pages (from-to)642-647
Number of pages6
JournalTransplantation
Volume97
Issue number6
DOIs
StatePublished - Mar 27 2014
Externally publishedYes

Fingerprint

Kidney Transplantation
Tissue Donors
Antibodies
Immunosuppression
Graft Survival
HLA Antigens
Allografts
Transplantation
Biopsy

Keywords

  • Donor-specific antibodies
  • Graft survival
  • Kidney transplantation
  • Outcomes
  • Rejection rates
  • Repeat transplantation

ASJC Scopus subject areas

  • Transplantation

Cite this

Tsapepas, D. S., Vasilescu, R., Tanriover, B., Coppleson, Y., Rekhtman, Y., Hardy, M. A., ... Mohan, S. (2014). Preformed donor-specific antibodies and risk of antibody-mediated rejection in repeat renal transplantation. Transplantation, 97(6), 642-647. https://doi.org/10.1097/01.TP.0000440954.14510.6a

Preformed donor-specific antibodies and risk of antibody-mediated rejection in repeat renal transplantation. / Tsapepas, Demetra S.; Vasilescu, Rodica; Tanriover, Bekir; Coppleson, Yael; Rekhtman, Yelena; Hardy, Mark A.; Dube, Geoffrey; Crew, R. John; Ratner, Lloyd E.; Cohen, David J.; Mohan, Sumit.

In: Transplantation, Vol. 97, No. 6, 27.03.2014, p. 642-647.

Research output: Contribution to journalArticle

Tsapepas, DS, Vasilescu, R, Tanriover, B, Coppleson, Y, Rekhtman, Y, Hardy, MA, Dube, G, Crew, RJ, Ratner, LE, Cohen, DJ & Mohan, S 2014, 'Preformed donor-specific antibodies and risk of antibody-mediated rejection in repeat renal transplantation', Transplantation, vol. 97, no. 6, pp. 642-647. https://doi.org/10.1097/01.TP.0000440954.14510.6a
Tsapepas, Demetra S. ; Vasilescu, Rodica ; Tanriover, Bekir ; Coppleson, Yael ; Rekhtman, Yelena ; Hardy, Mark A. ; Dube, Geoffrey ; Crew, R. John ; Ratner, Lloyd E. ; Cohen, David J. ; Mohan, Sumit. / Preformed donor-specific antibodies and risk of antibody-mediated rejection in repeat renal transplantation. In: Transplantation. 2014 ; Vol. 97, No. 6. pp. 642-647.
@article{d5eff0d5769d41e0ae5ecea970506b4e,
title = "Preformed donor-specific antibodies and risk of antibody-mediated rejection in repeat renal transplantation",
abstract = "BACKGROUND: Allograft outcomes in patients undergoing repeat renal transplantation are inferior compared to first-time transplant recipient outcomes. Donor-specific antibodies detected by solid-phase assays (DSA-SPA) may contribute to the worse prognosis. The influence of DSA-SPA on repeat renal transplantation outcomes has not been previously studied in detail. DESIGN: This study reports the findings in 174 patients who underwent repeat renal transplantation between years 2007 and 2012. These included 62 patients with preformed DSA-SPA detected by Luminex at the time of transplantation. Patients received standard and consistent immunosuppression and were monitored closely for evidence of rejection. Recipients who underwent desensitization were excluded from this analysis. Endpoints included development of biopsy-proven acute rejection and analysis of graft survival and function. RESULTS: Patients in the DSA-SPA-positive and DSA-SPA-negative groups received similar immunosuppression, and a similar proportion of recipients had a peak panel reactive antibody greater than 20{\%}; the two groups differed with respect to human leukocyte antigen mismatches (4.7±1.1 vs. 4.1±1.7, P=0.024). Recipients with preformed DSA-SPA had higher rejection rates (54.8{\%} vs. 34.8{\%}, P=0.01), including higher rates of antibody-mediated rejection (AMR) (32.3{\%} vs. 7.1{\%}, P",
keywords = "Donor-specific antibodies, Graft survival, Kidney transplantation, Outcomes, Rejection rates, Repeat transplantation",
author = "Tsapepas, {Demetra S.} and Rodica Vasilescu and Bekir Tanriover and Yael Coppleson and Yelena Rekhtman and Hardy, {Mark A.} and Geoffrey Dube and Crew, {R. John} and Ratner, {Lloyd E.} and Cohen, {David J.} and Sumit Mohan",
year = "2014",
month = "3",
day = "27",
doi = "10.1097/01.TP.0000440954.14510.6a",
language = "English (US)",
volume = "97",
pages = "642--647",
journal = "Transplantation",
issn = "0041-1337",
publisher = "Lippincott Williams and Wilkins",
number = "6",

}

TY - JOUR

T1 - Preformed donor-specific antibodies and risk of antibody-mediated rejection in repeat renal transplantation

AU - Tsapepas, Demetra S.

AU - Vasilescu, Rodica

AU - Tanriover, Bekir

AU - Coppleson, Yael

AU - Rekhtman, Yelena

AU - Hardy, Mark A.

AU - Dube, Geoffrey

AU - Crew, R. John

AU - Ratner, Lloyd E.

AU - Cohen, David J.

AU - Mohan, Sumit

PY - 2014/3/27

Y1 - 2014/3/27

N2 - BACKGROUND: Allograft outcomes in patients undergoing repeat renal transplantation are inferior compared to first-time transplant recipient outcomes. Donor-specific antibodies detected by solid-phase assays (DSA-SPA) may contribute to the worse prognosis. The influence of DSA-SPA on repeat renal transplantation outcomes has not been previously studied in detail. DESIGN: This study reports the findings in 174 patients who underwent repeat renal transplantation between years 2007 and 2012. These included 62 patients with preformed DSA-SPA detected by Luminex at the time of transplantation. Patients received standard and consistent immunosuppression and were monitored closely for evidence of rejection. Recipients who underwent desensitization were excluded from this analysis. Endpoints included development of biopsy-proven acute rejection and analysis of graft survival and function. RESULTS: Patients in the DSA-SPA-positive and DSA-SPA-negative groups received similar immunosuppression, and a similar proportion of recipients had a peak panel reactive antibody greater than 20%; the two groups differed with respect to human leukocyte antigen mismatches (4.7±1.1 vs. 4.1±1.7, P=0.024). Recipients with preformed DSA-SPA had higher rejection rates (54.8% vs. 34.8%, P=0.01), including higher rates of antibody-mediated rejection (AMR) (32.3% vs. 7.1%, P

AB - BACKGROUND: Allograft outcomes in patients undergoing repeat renal transplantation are inferior compared to first-time transplant recipient outcomes. Donor-specific antibodies detected by solid-phase assays (DSA-SPA) may contribute to the worse prognosis. The influence of DSA-SPA on repeat renal transplantation outcomes has not been previously studied in detail. DESIGN: This study reports the findings in 174 patients who underwent repeat renal transplantation between years 2007 and 2012. These included 62 patients with preformed DSA-SPA detected by Luminex at the time of transplantation. Patients received standard and consistent immunosuppression and were monitored closely for evidence of rejection. Recipients who underwent desensitization were excluded from this analysis. Endpoints included development of biopsy-proven acute rejection and analysis of graft survival and function. RESULTS: Patients in the DSA-SPA-positive and DSA-SPA-negative groups received similar immunosuppression, and a similar proportion of recipients had a peak panel reactive antibody greater than 20%; the two groups differed with respect to human leukocyte antigen mismatches (4.7±1.1 vs. 4.1±1.7, P=0.024). Recipients with preformed DSA-SPA had higher rejection rates (54.8% vs. 34.8%, P=0.01), including higher rates of antibody-mediated rejection (AMR) (32.3% vs. 7.1%, P

KW - Donor-specific antibodies

KW - Graft survival

KW - Kidney transplantation

KW - Outcomes

KW - Rejection rates

KW - Repeat transplantation

UR - http://www.scopus.com/inward/record.url?scp=84896603837&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=84896603837&partnerID=8YFLogxK

U2 - 10.1097/01.TP.0000440954.14510.6a

DO - 10.1097/01.TP.0000440954.14510.6a

M3 - Article

VL - 97

SP - 642

EP - 647

JO - Transplantation

JF - Transplantation

SN - 0041-1337

IS - 6

ER -