PMID- 32870149
OWN - NLM
STAT- MEDLINE
DCOM- 20210118
LR  - 20210118
IS  - 0301-0430 (Print)
IS  - 0301-0430 (Linking)
VI  - 94
IP  - 5
DP  - 2020 Nov
TI  - Pre-transplant AT1R antibodies and long-term outcomes in kidney transplant 
      recipients with a functioning graft for more than 5 years.
PG  - 245-251
LID - 10.5414/CN110250 [doi]
AB  - BACKGROUND: There is conflicting data regarding the association of pre-transplant 
      AT1R antibody levels and long-term outcomes following kidney transplantation. 
      MATERIALS AND METHODS: We examined the association between pre-transplant 
      antibodies and long-term graft outcome by assaying pre-transplant sera from 125 
      kidney transplant recipients from 1999 to 2009. RESULTS: The mean age at 
      transplant was 55.7 +/- 13 years; 67.2% were male, 87.2% were Caucasian, and 67.2% 
      received a deceased donor transplant. Induction therapy included 44.8% 
      thymoglobulin. Human leukocyte antigen (HLA) donor-specific antibodies (DSA) were 
      present in 22 (17.6%) patients, while AT1R antibodies > 17 U/mL were present in 
      24 (19.2%). The mean AT1R antibodies level was 13 +/- 7.2 U/mL. Patients were 
      followed-up for 7.1 +/- 1.9 years after transplant. Pre-transplant AT1R antibodies 
      were associated with rejection (p < 0.0001), antibody-mediated rejection (ABMR) 
      (p < 0.0001), and death-censored graft failure (DCGF) (p = 0.01). This was 
      confirmed by univariate Cox regression analyses for AT1R antibodies > 10 U/mL (HR 
      2.64, 95% Cl 1.35 - 5.17, p = 0.04) and AT1R antibodies > 17 U/mL (HR = 1.74, 95% 
      Cl 1.061 - 2.98, p = 0.04). Multivariable analyses did not retain AT1R antibodies 
      as independent predictors of DCGF; however, pre-transplant HLA, DSA, and acute 
      rejection during the first year were associated with DCGF (HR 2.07, 95% Cl 1.13 - 
      3.78, p = 0.02 and HR 3.03, 95% Cl 1.13 - 3.78, p = 0.0002, respectively). 
      CONCLUSION: Our study indicates that in patients with a functioning kidney 
      allograft > 5 years, pre-transplant AT1R antibodies may be associated with a 
      greater risk of rejection and late graft failure.
FAU - Aziz, Fahad
AU  - Aziz F
FAU - Jung-Hynes, Brittany
AU  - Jung-Hynes B
FAU - Parajuli, Sandesh
AU  - Parajuli S
FAU - Redfield, Robert R
AU  - Redfield RR
FAU - Astor, Brad C
AU  - Astor BC
FAU - Mandelbrot, Didier
AU  - Mandelbrot D
FAU - Hidalgo, Luis
AU  - Hidalgo L
FAU - Djamali, Arjang
AU  - Djamali A
LA  - eng
PT  - Journal Article
PL  - Germany
TA  - Clin Nephrol
JT  - Clinical nephrology
JID - 0364441
RN  - 0 (Autoantibodies)
RN  - 0 (HLA Antigens)
RN  - 0 (Receptor, Angiotensin, Type 1)
SB  - IM
MH  - Adult
MH  - Aged
MH  - Autoantibodies/*blood/immunology
MH  - Female
MH  - Graft Rejection/*etiology
MH  - HLA Antigens/immunology
MH  - Humans
MH  - Kidney Transplantation/*adverse effects/mortality
MH  - Male
MH  - Middle Aged
MH  - Receptor, Angiotensin, Type 1/*immunology
MH  - Time Factors
MH  - Transplantation, Homologous
EDAT- 2020/09/02 06:00
MHDA- 2021/01/20 06:00
CRDT- 2020/09/02 06:00
PHST- 2020/10/08 00:00 [accepted]
PHST- 2020/09/02 06:00 [pubmed]
PHST- 2021/01/20 06:00 [medline]
PHST- 2020/09/02 06:00 [entrez]
AID - 187226 [pii]
AID - 10.5414/CN110250 [doi]
PST - ppublish
SO  - Clin Nephrol. 2020 Nov;94(5):245-251. doi: 10.5414/CN110250.