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 language | English (US) |
|---|---|
| Pages (from-to) | 642-647 |
| Number of pages | 6 |
| Journal | Transplantation |
| Volume | 97 |
| Issue number | 6 |
| DOIs | |
| State | Published - Mar 27 2014 |
| Externally published | Yes |
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Keywords
- Donor-specific antibodies
- Graft survival
- Kidney transplantation
- Outcomes
- Rejection rates
- Repeat transplantation
ASJC Scopus subject areas
- Transplantation
Cite this
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 journal › Article
}
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
C2 - 24637863
AN - SCOPUS:84896603837
VL - 97
SP - 642
EP - 647
JO - Transplantation
JF - Transplantation
SN - 0041-1337
IS - 6
ER -