PMID- 25033258
OWN - NLM
STAT- MEDLINE
DCOM- 20150219
LR  - 20151119
IS  - 1534-6080 (Electronic)
IS  - 0041-1337 (Linking)
VI  - 99
IP  - 1
DP  - 2015 Jan
TI  - Posttransplant soluble B-cell activating factor kinetics in pediatric recipients 
      of first kidney allograft.
PG  - 243-9
LID - 10.1097/TP.0000000000000276 [doi]
AB  - BACKGROUND: Development of de novo donor-specific antibodies (dnDSA) is 
      associated with late or chronic antibody-mediated rejection (CAMR) and poor graft 
      outcome in low-risk kidney transplant recipients. High-level soluble B-cell 
      activating factor (sBAFF) was observed in kidney recipients at higher risk of 
      developing dnDSA. METHODS: We longitudinally analyzed sBAFF levels in 81 
      consecutive primary pediatric kidney recipients monitored for de novo human 
      leukocyte antigen (HLA) antibody (Ab) occurrence to gain insight into the events 
      conditioning B-cell activation posttransplant and to analyze the usefulness of 
      paired DSA-sBAFF monitoring in this clinical setting. RESULTS: At a median 
      follow-up of 65 months, 23 patients (28%) developed dnDSA, with 13 of 23 
      developing CAMR. Irrespective of HLA Ab status, sBAFF levels progressively 
      increased in all patients in the first posttransplant year, thereafter reaching a 
      plateau. sBAFF levels were influenced by the degree of HLA class I antigen match 
      and donor age. Despite higher levels of sBAFF in HLA Ab-positive patients (median 
      and 95% confidence interval sBAFF in DSA+non-DSA patients: 568, 534-608 pg/mL vs. 
      502, 422-548 pg/mL in Ab-negative patients; P<0.05), we found that sBAFF 
      monitoring could not predict DSA development by a time to event longitudinal 
      analysis. Moreover, sBAFF kinetics up to CAMR onset could not anticipate CAMR 
      development in the DSA cohort. CONCLUSION: Our findings provide evidence of early 
      posttransplant B-cell activation even in unsensitized recipients of first kidney 
      allograft. The significance of this activation, likely induced by exposition to 
      the allograft, is yet unclear.
FAU - Comoli, Patrizia
AU  - Comoli P
AD  - 1 Pediatric Hematology and Oncology, IRCCS Fondazione Policlinico S. Matteo, 
      Pavia, Italy. 2 Pediatric Nephrology, IRCCS Istituto G. Gaslini, Genova, Italy. 3 
      Nephrology Unit, Ospedale Presidio di Sestri Levante, Italy. 4 Transplant 
      Immunology, IRCCS Azienda Ospedaliera Universitaria S. Martino-Istituto Nazionale 
      per la Ricerca sul Cancro, Genova, Italy. 5 Department of Surgery, Kidney 
      Transplantation Unit, IRCCS Azienda Ospedaliera Universitaria S. Martino-Istituto 
      Nazionale per la Ricerca sul Cancro, Genova, Italy. 6Transplantation Immunology, 
      Fondazione Ca Granda Ospedale Maggiore Policlinico, Milan, Italy. 7 Biometry and 
      Clinical Epidemiology Service, IRCCS Fondazione Policlinico S. Matteo, Pavia, 
      Italy.
FAU - Quartuccio, Giuseppe
AU  - Quartuccio G
FAU - Cioni, Michela
AU  - Cioni M
FAU - Parodi, Angelica
AU  - Parodi A
FAU - Nocera, Arcangelo
AU  - Nocera A
FAU - Basso, Sabrina
AU  - Basso S
FAU - Fontana, Iris
AU  - Fontana I
FAU - Magnasco, Alberto
AU  - Magnasco A
FAU - Sioli, Viviana
AU  - Sioli V
FAU - Guido, Ilaria
AU  - Guido I
FAU - Klersy, Catherine
AU  - Klersy C
FAU - Zecca, Marco
AU  - Zecca M
FAU - Cardillo, Massimo
AU  - Cardillo M
FAU - Ghiggeri, Gian Marco
AU  - Ghiggeri GM
FAU - Ginevri, Fabrizio
AU  - Ginevri F
LA  - eng
PT  - Journal Article
PT  - Research Support, Non-U.S. Gov't
PL  - United States
TA  - Transplantation
JT  - Transplantation
JID - 0132144
RN  - 0 (B-Cell Activating Factor)
RN  - 0 (Biomarkers)
RN  - 0 (HLA Antigens)
RN  - 0 (Isoantibodies)
RN  - 0 (TNFSF13B protein, human)
SB  - IM
MH  - Acute Disease
MH  - Adolescent
MH  - Adult
MH  - Age Factors
MH  - B-Cell Activating Factor/*blood
MH  - Biomarkers/blood
MH  - Child
MH  - Child, Preschool
MH  - Female
MH  - Graft Rejection/blood/immunology
MH  - HLA Antigens/immunology
MH  - Humans
MH  - Isoantibodies/blood
MH  - *Kidney Transplantation
MH  - Kinetics
MH  - Longitudinal Studies
MH  - Male
MH  - Monitoring, Immunologic/methods
MH  - Predictive Value of Tests
MH  - Retrospective Studies
MH  - Risk Factors
MH  - Treatment Outcome
MH  - Up-Regulation
MH  - Young Adult
EDAT- 2014/07/18 06:00
MHDA- 2015/02/20 06:00
CRDT- 2014/07/18 06:00
PHST- 2014/07/18 06:00 [entrez]
PHST- 2014/07/18 06:00 [pubmed]
PHST- 2015/02/20 06:00 [medline]
AID - 10.1097/TP.0000000000000276 [doi]
PST - ppublish
SO  - Transplantation. 2015 Jan;99(1):243-9. doi: 10.1097/TP.0000000000000276.