PMID- 30980556
OWN - NLM
STAT- MEDLINE
DCOM- 20200331
LR  - 20211204
IS  - 1432-2277 (Electronic)
IS  - 0934-0874 (Linking)
VI  - 32
IP  - 9
DP  - 2019 Sep
TI  - Allosensitization after transplant failure: the role of graft nephrectomy and 
      immunosuppression - a retrospective study.
PG  - 949-959
LID - 10.1111/tri.13442 [doi]
AB  - There are conflicting data about the role of transplant nephrectomy and 
      immunosuppression withdrawal on the development of allosensitization and the 
      impact on re-transplantation. We divided 109 first graft recipients into two 
      groups according to whether they underwent nephrectomy (NX+, n = 61) or their 
      graft was left in situ (NX-, n = 48). Sera were assessed for HLA-A/B/Cw/DR/DQ 
      antibodies at the time of NX/transplant failure and after 3, 6, 12, 24 months. 
      The NX+ group showed a higher rate of donor specific antibody (DSA) and non-DSA 
      human leukocyte antigen (HLA) antibody production at all the time points. 
      Multivariable analysis showed that nephrectomy was a strong, independent risk 
      factor for the development of DSAs after 12 and 24 months (P = 0.005 and 0.008). 
      In the NX- group, low tacrolimus levels correlated with DSA formation (AUC 0.817, 
      P = 0.002; best cut-off level 2.9 ng/ml). Analysis with a standardized pool of UK 
      donors showed a more difficult grade of HLA matchability following nephrectomy 
      compared with the NX- group. Nephrectomy is followed by the long-term production 
      of DSA and non-DSA HLA antibodies and negatively impacts on the chances of 
      finding a HLA-compatible kidney. Tacrolimus levels >/=3 ng/ml are protective 
      against the development of allosensitization and could facilitate 
      re-transplantation in the NX- group.
CI  - (c) 2019 Steunstichting ESOT.
FAU - Lucisano, Gaetano
AU  - Lucisano G
AUID- ORCID: 0000-0001-8790-9927
AD  - Imperial College Renal and Transplant Centre, Imperial College Healthcare NHS 
      Trust, London, UK.
FAU - Brookes, Paul
AU  - Brookes P
AD  - Histocompatibility and Immunogenetics, Imperial College Healthcare NHS Trust, 
      London, UK.
FAU - Santos-Nunez, Eva
AU  - Santos-Nunez E
AD  - Histocompatibility and Immunogenetics, Imperial College Healthcare NHS Trust, 
      London, UK.
FAU - Firmin, Nicola
AU  - Firmin N
AD  - Histocompatibility and Immunogenetics, Imperial College Healthcare NHS Trust, 
      London, UK.
FAU - Gunby, Nicola
AU  - Gunby N
AD  - Histocompatibility and Immunogenetics, Imperial College Healthcare NHS Trust, 
      London, UK.
FAU - Hassan, Sevda
AU  - Hassan S
AD  - Imperial College Renal and Transplant Centre, Imperial College Healthcare NHS 
      Trust, London, UK.
FAU - Gueret-Wardle, Alexander
AU  - Gueret-Wardle A
AD  - Imperial College Renal and Transplant Centre, Imperial College Healthcare NHS 
      Trust, London, UK.
FAU - Herbert, Paul
AU  - Herbert P
AD  - Imperial College Renal and Transplant Centre, Imperial College Healthcare NHS 
      Trust, London, UK.
FAU - Papalois, Vassilios
AU  - Papalois V
AD  - Imperial College Renal and Transplant Centre, Imperial College Healthcare NHS 
      Trust, London, UK.
FAU - Willicombe, Michelle
AU  - Willicombe M
AD  - Imperial College Renal and Transplant Centre, Imperial College Healthcare NHS 
      Trust, London, UK.
FAU - Taube, David
AU  - Taube D
AD  - Imperial College Renal and Transplant Centre, Imperial College Healthcare NHS 
      Trust, London, UK.
LA  - eng
PT  - Journal Article
DEP - 20190426
PL  - Switzerland
TA  - Transpl Int
JT  - Transplant international : official journal of the European Society for Organ 
      Transplantation
JID - 8908516
RN  - 0 (Histocompatibility Antigens Class I)
RN  - 0 (Histocompatibility Antigens Class II)
RN  - 0 (Immunosuppressive Agents)
RN  - WM0HAQ4WNM (Tacrolimus)
SB  - IM
MH  - Adult
MH  - Aged
MH  - Female
MH  - Histocompatibility Antigens Class I/immunology
MH  - Histocompatibility Antigens Class II/immunology
MH  - Humans
MH  - *Immunosuppression Therapy
MH  - Immunosuppressive Agents/administration & dosage
MH  - Kidney Failure, Chronic/*immunology/surgery
MH  - Male
MH  - Middle Aged
MH  - Nephrectomy/*adverse effects
MH  - Postoperative Complications/*immunology/surgery
MH  - Retrospective Studies
MH  - Tacrolimus/administration & dosage
MH  - *Transplantation Immunology
OTO - NOTNLM
OT  - allosensitization
OT  - donor-specific antibody
OT  - tacrolimus
OT  - transplant nephrectomy
EDAT- 2019/04/14 06:00
MHDA- 2020/04/01 06:00
CRDT- 2019/04/14 06:00
PHST- 2018/11/22 00:00 [received]
PHST- 2019/01/07 00:00 [revised]
PHST- 2019/04/09 00:00 [accepted]
PHST- 2019/04/14 06:00 [pubmed]
PHST- 2020/04/01 06:00 [medline]
PHST- 2019/04/14 06:00 [entrez]
AID - 10.1111/tri.13442 [doi]
PST - ppublish
SO  - Transpl Int. 2019 Sep;32(9):949-959. doi: 10.1111/tri.13442. Epub 2019 Apr 26.