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Impact of pre-transplant anti-MICA sensitization in graft rejection and survival

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Resumo:Background: Evidence supporting deleterious effect of preformed major histocompatibility class I chain-related A (MICA) antibodies in rejection incidence and graft survival is still unclear. Methods: Retrospective analysis of 554 kidney transplanted patients. Comparison between positive or negative for MICA antibodies patients was performed to characterize sensitizing triggers. Further classification according to pre-transplant flow cytometry-recorded anti-MICA and/or anti-human leukocyte antigen (HLA) antibodies was made to determine first year rejection incidence and graft survival. Multivariate analysis was applied to determine predictors for acute rejection. Results: Pre-formed anti-MICA antibodies were detected in 41 patients (7.4%). HLA sensitization, blood transfusions and pregnancies were frequently found in anti-MICA+ patients but only pre-formed anti-HLA class I antibodies showed independent association (OR 2.67, p = 0.02). Comparing to MICA-/HLA-, MICA-/HLA+ group presented significantly lower first year rejection-free survival (78.6% vs. 89.3%, p < 0.01), mostly occurred in the first six months, while no difference was found in MICA+/HLA- (88.9% vs. 89.3%, p = ns). MICA-/HLA+ showed independent impact in rejection (OR 2.09, p = 0.03), while no evidence was found in MICA+/HLA- (OR 1.08, p = ns). At 4 years, MICA-/HLA+ group presented lower graft survival (85.8% vs. 95.3%, p = 0.03). Again, no difference was found in MICA+/HLA- group (95.1% vs. 95.3%, p = ns). Conclusion: Our results do not support HLA-independent deleterious pathogenic role of pre-formed MICA antibodies on first year rejection incidence and graft survival
Autores principais:Costa,Rui
Outros Autores:Malheiro,Jorge; Tafulo,Sandra; Santos,Clara; Almeida,Manuela; Pedroso,Sofia; Martins,La Salete; Dias,Leonídio; Castro-Henriques,António
Assunto:HLA kidney MICA rejection survival transplant
Ano:2015
País:Portugal
Tipo de documento:artigo
Tipo de acesso:acesso aberto
Instituição associada:Fundação para a Ciência e Tecnologia
Idioma:inglês
Origem:SciELO Portugal
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author Costa,Rui
author2 Malheiro,Jorge
Tafulo,Sandra
Santos,Clara
Almeida,Manuela
Pedroso,Sofia
Martins,La Salete
Dias,Leonídio
Castro-Henriques,António
author2_role author
author
author
author
author
author
author
author
author_facet Costa,Rui
Malheiro,Jorge
Tafulo,Sandra
Santos,Clara
Almeida,Manuela
Pedroso,Sofia
Martins,La Salete
Dias,Leonídio
Castro-Henriques,António
author_role author
country_str PT
creators_json_txt [{\"Person.name\":\"Costa,Rui\"},{\"Person.name\":\"Malheiro,Jorge\"},{\"Person.name\":\"Tafulo,Sandra\"},{\"Person.name\":\"Santos,Clara\"},{\"Person.name\":\"Almeida,Manuela\"},{\"Person.name\":\"Pedroso,Sofia\"},{\"Person.name\":\"Martins,La Salete\"},{\"Person.name\":\"Dias,Leonídio\"},{\"Person.name\":\"Castro-Henriques,António\"}]
datacite.creators.creator.creatorName.fl_str_mv Costa,Rui
Malheiro,Jorge
Tafulo,Sandra
Santos,Clara
Almeida,Manuela
Pedroso,Sofia
Martins,La Salete
Dias,Leonídio
Castro-Henriques,António
datacite.rights.fl_str_mv http://purl.org/coar/access_right/c_abf2
datacite.subjects.subject.fl_str_mv HLA
kidney
MICA
rejection
survival
transplant
datacite.titles.title.fl_str_mv Impact of pre-transplant anti-MICA sensitization in graft rejection and survival
dc.creator.none.fl_str_mv Costa,Rui
Malheiro,Jorge
Tafulo,Sandra
Santos,Clara
Almeida,Manuela
Pedroso,Sofia
Martins,La Salete
Dias,Leonídio
Castro-Henriques,António
dc.format.none.fl_str_mv text/html
dc.identifier.none.fl_str_mv http://scielo.pt/scielo.php?script=sci_arttext&pid=S0872-01692015000200005
dc.language.none.fl_str_mv eng
dc.publisher.none.fl_str_mv Sociedade Portuguesa de Nefrologia
dc.rights.none.fl_str_mv http://purl.org/coar/access_right/c_abf2
dc.source.none.fl_str_mv Portuguese Journal of Nephrology &amp; Hypertension v.29 n.2 2015
dc.subject.none.fl_str_mv HLA
kidney
MICA
rejection
survival
transplant
dc.title.fl_str_mv Impact of pre-transplant anti-MICA sensitization in graft rejection and survival
dc.type.none.fl_str_mv http://purl.org/coar/resource_type/c_6501
description Background: Evidence supporting deleterious effect of preformed major histocompatibility class I chain-related A (MICA) antibodies in rejection incidence and graft survival is still unclear. Methods: Retrospective analysis of 554 kidney transplanted patients. Comparison between positive or negative for MICA antibodies patients was performed to characterize sensitizing triggers. Further classification according to pre-transplant flow cytometry-recorded anti-MICA and/or anti-human leukocyte antigen (HLA) antibodies was made to determine first year rejection incidence and graft survival. Multivariate analysis was applied to determine predictors for acute rejection. Results: Pre-formed anti-MICA antibodies were detected in 41 patients (7.4%). HLA sensitization, blood transfusions and pregnancies were frequently found in anti-MICA+ patients but only pre-formed anti-HLA class I antibodies showed independent association (OR 2.67, p = 0.02). Comparing to MICA-/HLA-, MICA-/HLA+ group presented significantly lower first year rejection-free survival (78.6% vs. 89.3%, p < 0.01), mostly occurred in the first six months, while no difference was found in MICA+/HLA- (88.9% vs. 89.3%, p = ns). MICA-/HLA+ showed independent impact in rejection (OR 2.09, p = 0.03), while no evidence was found in MICA+/HLA- (OR 1.08, p = ns). At 4 years, MICA-/HLA+ group presented lower graft survival (85.8% vs. 95.3%, p = 0.03). Again, no difference was found in MICA+/HLA- group (95.1% vs. 95.3%, p = ns). Conclusion: Our results do not support HLA-independent deleterious pathogenic role of pre-formed MICA antibodies on first year rejection incidence and graft survival
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person_str_mv Costa,Rui
Malheiro,Jorge
Tafulo,Sandra
Santos,Clara
Almeida,Manuela
Pedroso,Sofia
Martins,La Salete
Dias,Leonídio
Castro-Henriques,António
publishDate 2015
publisher.none.fl_str_mv Sociedade Portuguesa de Nefrologia
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spelling Impact of pre-transplant anti-MICA sensitization in graft rejection and survivalCosta,RuiMalheiro,JorgeTafulo,SandraSantos,ClaraAlmeida,ManuelaPedroso,SofiaMartins,La SaleteDias,LeonídioCastro-Henriques,AntónioHLAkidneyMICArejectionsurvivaltransplantopen accesshttp://purl.org/coar/access_right/c_abf2http://scielo.pt/scielo.php?script=sci_arttext&pid=S0872-01692015000200005URLhttp://scielo.pt/scielo.php?script=sci_arttext&pid=S0872-01692015000200005URLHasVersion2015-06-01Background: Evidence supporting deleterious effect of preformed major histocompatibility class I chain-related A (MICA) antibodies in rejection incidence and graft survival is still unclear. Methods: Retrospective analysis of 554 kidney transplanted patients. Comparison between positive or negative for MICA antibodies patients was performed to characterize sensitizing triggers. Further classification according to pre-transplant flow cytometry-recorded anti-MICA and/or anti-human leukocyte antigen (HLA) antibodies was made to determine first year rejection incidence and graft survival. Multivariate analysis was applied to determine predictors for acute rejection. Results: Pre-formed anti-MICA antibodies were detected in 41 patients (7.4%). HLA sensitization, blood transfusions and pregnancies were frequently found in anti-MICA+ patients but only pre-formed anti-HLA class I antibodies showed independent association (OR 2.67, p = 0.02). Comparing to MICA-/HLA-, MICA-/HLA+ group presented significantly lower first year rejection-free survival (78.6% vs. 89.3%, p < 0.01), mostly occurred in the first six months, while no difference was found in MICA+/HLA- (88.9% vs. 89.3%, p = ns). MICA-/HLA+ showed independent impact in rejection (OR 2.09, p = 0.03), while no evidence was found in MICA+/HLA- (OR 1.08, p = ns). At 4 years, MICA-/HLA+ group presented lower graft survival (85.8% vs. 95.3%, p = 0.03). Again, no difference was found in MICA+/HLA- group (95.1% vs. 95.3%, p = ns). Conclusion: Our results do not support HLA-independent deleterious pathogenic role of pre-formed MICA antibodies on first year rejection incidence and graft survivalSociedade Portuguesa de NefrologiaPortuguese Journal of Nephrology &amp; Hypertension v.29 n.2 2015text/htmlengjournal articlehttp://purl.org/coar/resource_type/c_6501literature
spellingShingle Impact of pre-transplant anti-MICA sensitization in graft rejection and survival
Costa,Rui
HLA
kidney
MICA
rejection
survival
transplant
status SINGLETON
subject.fl_str_mv HLA
kidney
MICA
rejection
survival
transplant
title Impact of pre-transplant anti-MICA sensitization in graft rejection and survival
title_full Impact of pre-transplant anti-MICA sensitization in graft rejection and survival
title_fullStr Impact of pre-transplant anti-MICA sensitization in graft rejection and survival
title_full_unstemmed Impact of pre-transplant anti-MICA sensitization in graft rejection and survival
title_short Impact of pre-transplant anti-MICA sensitization in graft rejection and survival
title_sort Impact of pre-transplant anti-MICA sensitization in graft rejection and survival
topic HLA
kidney
MICA
rejection
survival
transplant
topic_facet HLA
kidney
MICA
rejection
survival
transplant
url http://scielo.pt/scielo.php?script=sci_arttext&pid=S0872-01692015000200005
visible 1