PMID- 27234729
OWN - NLM
STAT- MEDLINE
DCOM- 20170106
LR  - 20220311
IS  - 1873-2623 (Electronic)
IS  - 0041-1345 (Linking)
VI  - 48
IP  - 3
DP  - 2016 Apr
TI  - Role of Pretransplant Complement-fixing Donor-specific Antibodies Identified by 
      C1q Assay in Kidney Transplantation.
PG  - 756-60
LID - S0041-1345(16)00236-0 [pii]
LID - 10.1016/j.transproceed.2015.12.116 [doi]
AB  - BACKGROUND: Kidney transplant recipients who have pretransplant donor-specific 
      human leukocyte antigen (HLA) antibodies have greater risk for developing 
      allograft rejection and allograft loss. However, there is a varied effect of 
      graft injury among patients with pretransplantation donor-specific antibodies 
      (DSA). The difference of complement activating ability may be the reason why some 
      DSA are detrimental to kidney allograft. This study aimed to investigate the 
      association between pretransplantation C1q-binding DSA and clinical outcomes. 
      METHODS: This retrospective study included 48 pretransplant sera from kidney 
      transplant recipients who had pretransplant DSA with negative 
      complement-dependent cytotoxic (CDC) crossmatches. The IgG DSA testing and C1q 
      testing were performed on a Luminex platform with single antigen bead assay. The 
      clinical outcomes between C1q-positive and C1q-negative groups were compared. 
      RESULTS: C1q-positive DSA were detected in 12 out of 48 patients (25%). The 
      incidences of antibody-mediated rejection (AMR) were higher among patients with 
      C1q-positive DSA than patients with C1q-negative DSA (66.7% vs 41.7%). 
      Nevertheless, there were no statistically significant associations between 
      C1q-DSA and AMR (odds ratio 2.8, 95% CI 0.68-11.6, P = .13) and between C1q-DSA 
      and graft loss (odds ratio 0.52, 95% CI 0.09-2.89, P = .44). The C1q-positive DSA 
      group had significantly higher IgG DSA MFI than the C1q-negative DSA group (P < 
      .001). CONCLUSION: C1q-binding ability of DSA in pretransplant sera of kidney 
      recipients was not associated with antibody-mediated rejection and graft loss 
      post-transplantation. In contrast with the clinical relevance of C1q testing in 
      the post-transplantation setting, C1q testing in pretransplant sera has limited 
      use for immunological risk assessment.
CI  - Copyright (c) 2016 Elsevier Inc. All rights reserved.
FAU - Thammanichanond, D
AU  - Thammanichanond D
AD  - Histocompatibility and Immunogenetics Laboratory, Department of Pathology, 
      Faculty of Medicine, Ramathibodi Hospital, Mahidol University, Bangkok, Thailand. 
      Electronic address: duangtawan.tha@mahidol.ac.th.
FAU - Wiwattanathum, P
AU  - Wiwattanathum P
AD  - Nephrology Unit, Department of Medicine, Faculty of Medicine, Ramathibodi 
      Hospital, Mahidol University, Bangkok, Thailand.
FAU - Mongkolsuk, T
AU  - Mongkolsuk T
AD  - Histocompatibility and Immunogenetics Laboratory, Department of Pathology, 
      Faculty of Medicine, Ramathibodi Hospital, Mahidol University, Bangkok, Thailand.
FAU - Kantachuvesiri, S
AU  - Kantachuvesiri S
AD  - Nephrology Unit, Department of Medicine, Faculty of Medicine, Ramathibodi 
      Hospital, Mahidol University, Bangkok, Thailand.
FAU - Worawichawong, S
AU  - Worawichawong S
AD  - Immunopathology Laboratory, Department of Pathology, Faculty of Medicine, 
      Ramathibodi Hospital, Mahidol University, Bangkok, Thailand.
FAU - Vallipakorn, S A
AU  - Vallipakorn SA
AD  - Section for Clinical Epidemiology and Biostatistics, Faculty of Medicine, 
      Ramathibodi Hospital, Mahidol University, Bangkok, Thailand.
FAU - Kitpoka, P
AU  - Kitpoka P
AD  - Histocompatibility and Immunogenetics Laboratory, Department of Pathology, 
      Faculty of Medicine, Ramathibodi Hospital, Mahidol University, Bangkok, Thailand.
LA  - eng
PT  - Journal Article
PL  - United States
TA  - Transplant Proc
JT  - Transplantation proceedings
JID - 0243532
RN  - 0 (HLA Antigens)
RN  - 0 (Immunoglobulin G)
RN  - 80295-33-6 (Complement C1q)
SB  - IM
MH  - Adult
MH  - Complement Activation
MH  - Complement C1q/*immunology
MH  - Female
MH  - Graft Rejection/blood/immunology
MH  - HLA Antigens/blood/immunology
MH  - Humans
MH  - Immunoglobulin G/blood
MH  - *Kidney Transplantation
MH  - Male
MH  - Middle Aged
MH  - Preoperative Period
MH  - Retrospective Studies
MH  - Risk Assessment
MH  - *Tissue Donors
MH  - Transplant Recipients
EDAT- 2016/05/29 06:00
MHDA- 2017/01/07 06:00
CRDT- 2016/05/29 06:00
PHST- 2015/11/30 00:00 [received]
PHST- 2015/12/30 00:00 [accepted]
PHST- 2016/05/29 06:00 [entrez]
PHST- 2016/05/29 06:00 [pubmed]
PHST- 2017/01/07 06:00 [medline]
AID - S0041-1345(16)00236-0 [pii]
AID - 10.1016/j.transproceed.2015.12.116 [doi]
PST - ppublish
SO  - Transplant Proc. 2016 Apr;48(3):756-60. doi: 10.1016/j.transproceed.2015.12.116.