PMID- 24879384
OWN - NLM
STAT- MEDLINE
DCOM- 20150727
LR  - 20220408
IS  - 1534-6080 (Electronic)
IS  - 0041-1337 (Linking)
VI  - 98
IP  - 12
DP  - 2014 Dec 27
TI  - De novo donor-specific human leukocyte antigen antibodies early after kidney 
      transplantation.
PG  - 1310-5
LID - 10.1097/TP.0000000000000216 [doi]
AB  - BACKGROUND: Our aim was to determine the incidence of de novo donor-specific 
      human leukocyte antigen (HLA) antibody (dnDSA) during the first year after kidney 
      transplantation and the impact of early dnDSA on acute rejection and protocol 
      biopsy findings. METHODS: We selected all patients who received a kidney 
      transplant at our center between July 2010 and March 2012. Single antigen bead 
      assay was performed at 1, 4 and 12 months after transplantation. Only DSAs with a 
      mean fluorescence intensity (MFI) of greater 999 were included. RESULTS: We 
      included 245 kidney transplant recipients who did not have a DSA before 
      transplantation. At 12 months, 8.2% of the patients developed dnDSA; 2.4% of them 
      were to HLA class I and 6.5% to HLA class II. Of the 32 patients with a dnDSA at 
      1 or 4 months, only 8 (25%) persisted at 12 months. The risk of antibody-mediated 
      rejection (AMR) was higher in the dnDSA group. For the dnDSA group with MFI of 
      3,000 or greater (compared with the group with MFI<3,000), the hazard ratio for 
      AMR was 10.6 (95% confidence interval, 2.27-49.5). The cumulative incidence of 
      AMR or mixed rejection at 1 year was 30% in the group with dnDSA MFI level of 
      3,000 or greater but only 4% for the group with dnDSA with MFI less than 3,000. 
      On 1-year protocol biopsies, the dnDSA group showed more interstitial 
      inflammation, tubulitis, and glomerulitis. CONCLUSION: We conclude that dnDSA 
      occurring during the first posttransplantation year may be transient, and the 
      risk of AMR is higher in patients with a dnDSA MFI level that is greater than 
      3,000.
FAU - Heilman, Raymond L
AU  - Heilman RL
AD  - 1 Department of Medicine, Mayo Clinic, Phoenix, AZ. 2 Department of Pathology and 
      Laboratory Medicine, Mayo Clinic, Phoenix, AZ. 3 Department of Surgery, Mayo 
      Clinic, Phoenix, AZ. 4 Address correspondence to: Raymond L. Heilman, M.D., 
      Department of Medicine, Mayo Clinic, 5777 East Mayo Blvd, Phoenix, AZ 85054.
FAU - Nijim, Ala
AU  - Nijim A
FAU - Desmarteau, Yvonne M
AU  - Desmarteau YM
FAU - Khamash, Hasan
AU  - Khamash H
FAU - Pando, Marcelo Jorge
AU  - Pando MJ
FAU - Smith, Maxwell L
AU  - Smith ML
FAU - Chakkera, Harini A
AU  - Chakkera HA
FAU - Huskey, Janna
AU  - Huskey J
FAU - Valdez, Riccardo
AU  - Valdez R
FAU - Reddy, Kunam Sudhakar
AU  - Reddy KS
LA  - eng
PT  - Journal Article
PL  - United States
TA  - Transplantation
JT  - Transplantation
JID - 0132144
RN  - 0 (Antibodies)
RN  - 0 (HLA Antigens)
RN  - 0 (Histocompatibility Antigens Class I)
RN  - 0 (Histocompatibility Antigens Class II)
SB  - IM
MH  - Adult
MH  - Aged
MH  - Antibodies/immunology
MH  - Biopsy
MH  - Cohort Studies
MH  - Female
MH  - Graft Rejection/immunology
MH  - HLA Antigens/*immunology
MH  - Histocompatibility Antigens Class I/immunology
MH  - Histocompatibility Antigens Class II/immunology
MH  - Histocompatibility Testing
MH  - Humans
MH  - Kidney Failure, Chronic/*immunology/*surgery
MH  - Kidney Transplantation
MH  - Male
MH  - Middle Aged
MH  - Retrospective Studies
MH  - Time Factors
EDAT- 2014/06/01 06:00
MHDA- 2015/07/28 06:00
CRDT- 2014/06/01 06:00
PHST- 2014/06/01 06:00 [entrez]
PHST- 2014/06/01 06:00 [pubmed]
PHST- 2015/07/28 06:00 [medline]
AID - 10.1097/TP.0000000000000216 [doi]
PST - ppublish
SO  - Transplantation. 2014 Dec 27;98(12):1310-5. doi: 10.1097/TP.0000000000000216.