PMID- 23726594
OWN - NLM
STAT- MEDLINE
DCOM- 20131230
LR  - 20130603
IS  - 1873-2623 (Electronic)
IS  - 0041-1345 (Linking)
VI  - 45
IP  - 4
DP  - 2013 May
TI  - The impact of de novo donor-specific anti-human leukocyte antigen antibodies on 
      5-year renal transplant outcome.
PG  - 1449-52
LID - S0041-1345(13)00083-3 [pii]
LID - 10.1016/j.transproceed.2012.12.026 [doi]
AB  - Numerous studies have shown that circulating donor-specific antibodies targeting 
      human leukocyte antigen (HLA) are associated with accelerated renal transplant 
      failure, but many patients with these antibodies have good graft function. The 
      aim of our study was to investigate the long-term graft function and survival in 
      patients with de novo post-transplant donor-specific anti-HLA antibodies (DSA). 
      Our prospective study included 78 consecutive recipients with a negative 
      crossmatch before transplantation. Recipient serum samples were assayed for DSA 
      in week 2 and 1, 3, 6, 9, 12 months after transplantation using a 
      complement-dependent lymphocytotoxic technique with donor lymphocytes. 
      Additionally, patients with DSA and stable renal function in the first year were 
      tested with a more sensitive flow-panel-reactive antibody. DSA were present in 34 
      (44%) of our patients during the first 12 months after transplantation. 
      Biopsy-proved acute rejection occurred in 11 DSA-positive and 10 DSA-negative 
      patients. Seven DSA-positive patients had antibody-mediated rejection and no 
      DSA-negative ones developed humoral rejection. The serum creatinine level in 
      DSA-positive patients was significantly higher (2.48 vs 1.43 mg/dL) in year 5. 
      The 13 (38%) DSA-positive patients with good graft function in month 12 were 
      stable during a 5-year follow-up: their serum creatinine was 1.46 +/- 0.4 in year 1 
      and 1.56 +/- 0.4 mg/dL in year 5 and nobody lost their allograft. One- and 5- year 
      graft survivals were appropriately 85% and 59% in DSA-positive patients compared 
      to 93% and 93% in DSA-negative patients. To sum up, post-transplant DSA had a 
      significant influence on kidney function and graft survival but in 38% of 
      patients the presence of DSA did not decrease a 5-year renal function. A good 
      renal allograft function in the presence of DSA in the first year after 
      transplantation and cessation of their production in the subsequent years may be 
      a good prognostic marker for a long-term allograft function and survival.
CI  - Copyright (c) 2013 Elsevier Inc. All rights reserved.
FAU - Banasik, M
AU  - Banasik M
AD  - Department of Nephrology and Transplantation Medicine, Wroclaw Medical 
      University, Wroclaw, Poland. m.banasik@interia.pl
FAU - Boratynska, M
AU  - Boratynska M
FAU - Koscielska-Kasprzak, K
AU  - Koscielska-Kasprzak K
FAU - Mazanowska, O
AU  - Mazanowska O
FAU - Krajewska, M
AU  - Krajewska M
FAU - Zabinska, M
AU  - Zabinska M
FAU - Bartoszek, D
AU  - Bartoszek D
FAU - Myszka, M
AU  - Myszka M
FAU - Nowakowska, B
AU  - Nowakowska B
FAU - Dawiskiba, T
AU  - Dawiskiba T
FAU - Lepiesza, A
AU  - Lepiesza A
FAU - Chudoba, P
AU  - Chudoba P
FAU - Klinger, M
AU  - Klinger M
LA  - eng
PT  - Journal Article
PL  - United States
TA  - Transplant Proc
JT  - Transplantation proceedings
JID - 0243532
RN  - 0 (Autoantibodies)
RN  - 0 (HLA Antigens)
SB  - IM
MH  - Adult
MH  - Autoantibodies/*administration & dosage/immunology
MH  - Female
MH  - Follow-Up Studies
MH  - HLA Antigens/*immunology
MH  - Humans
MH  - *Kidney Transplantation
MH  - Male
MH  - Middle Aged
MH  - Treatment Outcome
EDAT- 2013/06/04 06:00
MHDA- 2014/01/01 06:00
CRDT- 2013/06/04 06:00
PHST- 2012/11/21 00:00 [received]
PHST- 2012/12/31 00:00 [accepted]
PHST- 2013/06/04 06:00 [entrez]
PHST- 2013/06/04 06:00 [pubmed]
PHST- 2014/01/01 06:00 [medline]
AID - S0041-1345(13)00083-3 [pii]
AID - 10.1016/j.transproceed.2012.12.026 [doi]
PST - ppublish
SO  - Transplant Proc. 2013 May;45(4):1449-52. doi: 10.1016/j.transproceed.2012.12.026.