Author(s): Santos, S. ; Malheiro, J. ; Tafulo, S. ; Dias, L. ; Carmo, R. ; Sampaio, S. ; Costa, M. ; Campos, A. ; Pedroso, S. ; Almeida, M. ; Martins, L. ; Henriques, C. ; Cabrita, A.
Date: 2016
Persistent ID: http://hdl.handle.net/10400.16/2161
Origin: Repositório Científico da Unidade Local de Saúde de Santo António (ULSSA)
Subject(s): Anti human leukocyte antigen class I; AntiHLA-Cw antibodies; Antibody-mediated rejection; Donor-specific antibodies; Graft survival; Solid-phase immunoassays
AIM: To analyze the clinical impact of preformed antiHLA-Cw vs antiHLA-A and/or -B donor-specific antibodies (DSA) in kidney transplantation. METHODS: Retrospective study, comparing 12 patients transplanted with DSA exclusively antiHLA-Cw with 23 patients with preformed DSA antiHLA-A and/or B. RESULTS: One year after transplantation there were no differences in terms of acute rejection between the two groups (3 and 6 cases, respectively in the DSA-Cw and the DSA-A-B groups; P = 1). At one year, eGFR was not significantly different between groups (median 59 mL/min in DSA-Cw group, compared to median 51 mL/min in DSA-A-B group, P = 0.192). Moreover, kidney graft survival was similar between groups at 5-years (100% in DSA-Cw group vs 91% in DSA-A-B group, P = 0.528). The sole independent predictor of antibody mediated rejection (AMR) incidence was DSA strength (HR = 1.07 per 1000 increase in MFI, P = 0.034). AMR was associated with shortened graft survival at 5-years, with 75% and 100% grafts surviving in patients with or without AMR, respectively (Log-rank P = 0.005). CONCLUSION: Our data indicate that DSA-Cw are associated with an identical risk of AMR and impact on graft function in comparison with "classical" class I DSA.
