PMID- 19424037
OWN - NLM
STAT- MEDLINE
DCOM- 20090708
LR  - 20090916
IS  - 1534-6080 (Electronic)
IS  - 0041-1337 (Linking)
VI  - 87
IP  - 9
DP  - 2009 May 15
TI  - HLA antibodies and the occurrence of early adverse events in the modern era of 
      transplantation: a collaborative transplant study report.
PG  - 1367-71
LID - 10.1097/TP.0b013e3181a24073 [doi]
AB  - BACKGROUND: Adverse events occurring early after kidney transplantation were 
      reported to influence graft outcome. METHODS: In a prospective multicenter study 
      initiated in 2001, we investigated the relationship between human leukocyte 
      antigen (HLA) alloantibodies, early adverse events, and graft outcome. RESULTS: 
      Pretransplant presence of HLA class I antibodies was associated with a higher 
      rate of no immediate function (NIF) of the graft (odds ratio [OR] 1.78, P=0.023) 
      and acute rejection episodes (ARE) during the first 3 months after 
      transplantation (OR 2.53, P<0.001). NIF and ARE during posttransplant days 15 to 
      90 were associated with increased risk of graft loss to year 3 (OR 2.06 and 3.75, 
      P=0.006 and P<0.001, respectively). ARE within the first 2 posttransplant weeks 
      did not increase the risk significantly, especially if they occurred in 
      nonsensitized patients without antibodies. Graft survival at 3 years in patients 
      with both NIF and ARE during the first 3 months was significantly lower 
      (81.3%+/-6.2%) than in patients who did not experience NIF or ARE (95.1%+/-1.0%, 
      P<0.001). Importantly, neither NIF nor ARE had an impact on subsequent graft 
      survival if good graft function (serum creatinine <130 mumol/L) was observed at 
      the end of the third month. CONCLUSION: Our results show that NIF and ARE 
      associated with pretransplant antibodies against HLA class I, and they suggest 
      that early diagnosis and treatment of adverse events with the aim of obtaining 
      normal 3-month graft function should be pursued rigorously. Good 3-month graft 
      function is associated with excellent long-term survival, even in patients with 
      pretransplant HLA antibodies and posttransplant adverse events.
FAU - Susal, Caner
AU  - Susal C
AD  - Department of Transplantation Immunology, Institute of Immunology, University of 
      Heidelberg, Heidelberg, Germany. caner.suesal@med.uni-heidelberg.de
FAU - Dohler, Bernd
AU  - Dohler B
FAU - Sadeghi, Mahmoud
AU  - Sadeghi M
FAU - Ovens, Jorg
AU  - Ovens J
FAU - Opelz, Gerhard
AU  - Opelz G
LA  - eng
PT  - Journal Article
PT  - Multicenter Study
PL  - United States
TA  - Transplantation
JT  - Transplantation
JID - 0132144
RN  - 0 (Autoantibodies)
RN  - 0 (HLA Antigens)
SB  - IM
EIN - Transplantation. 2009 Jul 27;88(2):293
MH  - Adult
MH  - Aged
MH  - Autoantibodies/*blood
MH  - Female
MH  - Graft Rejection/epidemiology
MH  - Graft Survival
MH  - HLA Antigens/*immunology
MH  - Humans
MH  - Kidney Transplantation/adverse effects/*immunology/mortality
MH  - Male
MH  - Middle Aged
MH  - Multivariate Analysis
MH  - Prospective Studies
MH  - Reoperation/statistics & numerical data
MH  - Survival Analysis
MH  - *Transplantation Immunology
MH  - Treatment Failure
EDAT- 2009/05/09 09:00
MHDA- 2009/07/09 09:00
CRDT- 2009/05/09 09:00
PHST- 2009/05/09 09:00 [entrez]
PHST- 2009/05/09 09:00 [pubmed]
PHST- 2009/07/09 09:00 [medline]
AID - 00007890-200905150-00016 [pii]
AID - 10.1097/TP.0b013e3181a24073 [doi]
PST - ppublish
SO  - Transplantation. 2009 May 15;87(9):1367-71. doi: 10.1097/TP.0b013e3181a24073.