PMID- 21116220
OWN - NLM
STAT- MEDLINE
DCOM- 20110307
LR  - 20151119
IS  - 1534-6080 (Electronic)
IS  - 0041-1337 (Linking)
VI  - 91
IP  - 3
DP  - 2011 Feb 15
TI  - C1q-fixing human leukocyte antigen antibodies are specific for predicting 
      transplant glomerulopathy and late graft failure after kidney transplantation.
PG  - 342-7
LID - 10.1097/TP.0b013e318203fd26 [doi]
AB  - BACKGROUND: Human leukocyte antigen (HLA) antibodies, especially those that fix 
      complement, are associated with antibody-mediated rejection and graft failure. 
      The C1q assay on single antigen beads detects a subset of HLA antibodies that can 
      fix complement and precede C4d deposition. The aim of this study was to determine 
      whether C1q-fixing antibodies distinguish de novo donor-specific antibodies (DSA) 
      that are clinically relevant and harmful. METHODS: We retrospectively studied 31 
      of 274 kidney transplant recipients who had pretransplant and concurrent biopsy 
      and serum specimens, 13 with C4d-positive and 18 with C4d-negative staining. We 
      measured IgG and C1q DSA pretransplant and at the time of biopsy using single 
      antigen bead assays. We identified 13 recipients who developed de novo DSA by IgG 
      or C1q and examined associations with C4d deposition, transplant glomerulopathy, 
      and graft failure. RESULTS: Testing for DSA by IgG is more sensitive for C4d 
      deposition (IgG: 100%, 95% confidence interval [CI] 0.60-1; C1q: 75%, 95% CI 
      0.36-0.96). Testing for DSA by C1q is more specific for transplant glomerulopathy 
      (C1q: 81%, 95% CI 0.57-0.94; IgG: 67%, 95% CI 0.43-0.85) and graft loss (C1q: 
      79%, 95% CI 0.54-0.93; IgG: 63%, 95% CI 0.39-0.83). Absence of de novo DSA by IgG 
      and C1q has a high negative predictive value for the absence of C4d deposition 
      (IgG: 100%, 95% CI 0.73-1; C1q: 88%, 95% CI 0.62-0.98), transplant glomerulopathy 
      (IgG: 100%, 95% CI 0.73-1; C1q: 100%, 95% CI 0.77-1), and graft failure (IgG: 
      86%, 95% CI 0.56-0.97; C1q: 88%, 95% CI 0.62-0.98). CONCLUSION: Monitoring 
      patients with the C1q assay, which detects antibodies that fix complement, offers 
      a minimally invasive means of identifying patients at risk for transplant 
      glomerulopathy and graft loss.
FAU - Yabu, Julie M
AU  - Yabu JM
AD  - Division of Nephrology, Department of Medicine, Stanford University, Palo Alto, 
      CA 90095-7430, USA.
FAU - Higgins, John P
AU  - Higgins JP
FAU - Chen, Ge
AU  - Chen G
FAU - Sequeira, Flavia
AU  - Sequeira F
FAU - Busque, Stephan
AU  - Busque S
FAU - Tyan, Dolly B
AU  - Tyan DB
LA  - eng
PT  - Journal Article
PL  - United States
TA  - Transplantation
JT  - Transplantation
JID - 0132144
RN  - 0 (Antibodies)
RN  - 0 (Biomarkers)
RN  - 0 (HLA Antigens)
RN  - 0 (Peptide Fragments)
RN  - 80295-33-6 (Complement C1q)
RN  - 80295-50-7 (Complement C4b)
RN  - 80295-52-9 (complement C4d)
SB  - IM
MH  - Adult
MH  - Antibodies/*blood
MH  - Biomarkers/blood
MH  - Biopsy
MH  - Complement C1q/*immunology
MH  - Complement C4b/metabolism
MH  - Female
MH  - Follow-Up Studies
MH  - Graft Rejection/blood/*epidemiology
MH  - HLA Antigens/*immunology
MH  - Humans
MH  - Kaplan-Meier Estimate
MH  - Kidney/metabolism/pathology
MH  - Kidney Diseases/blood/*epidemiology
MH  - *Kidney Transplantation
MH  - Male
MH  - Middle Aged
MH  - Peptide Fragments/metabolism
MH  - Pilot Projects
MH  - Predictive Value of Tests
MH  - Retrospective Studies
MH  - Risk Factors
MH  - Sensitivity and Specificity
EDAT- 2010/12/01 06:00
MHDA- 2011/03/08 06:00
CRDT- 2010/12/01 06:00
PHST- 2010/12/01 06:00 [entrez]
PHST- 2010/12/01 06:00 [pubmed]
PHST- 2011/03/08 06:00 [medline]
AID - 10.1097/TP.0b013e318203fd26 [doi]
PST - ppublish
SO  - Transplantation. 2011 Feb 15;91(3):342-7. doi: 10.1097/TP.0b013e318203fd26.