PMID- 32983110
OWN - NLM
STAT- MEDLINE
DCOM- 20210419
LR  - 20210419
IS  - 1664-3224 (Electronic)
IS  - 1664-3224 (Linking)
VI  - 11
DP  - 2020
TI  - Pre-transplant HLA Antibodies and Delayed Graft Function in the Current Era of 
      Kidney Transplantation.
PG  - 1886
LID - 10.3389/fimmu.2020.01886 [doi]
LID - 1886
AB  - Delayed graft function (DGF) occurs in a significant proportion of deceased donor 
      kidney transplant recipients and was associated with graft injury and inferior 
      clinical outcome. The aim of the present multi-center study was to identify the 
      immunological and non-immunological predictors of DGF and to determine its 
      influence on outcome in the presence and absence of human leukocyte antigen (HLA) 
      antibodies. 1,724 patients who received a deceased donor kidney transplant during 
      2008-2017 and on whom a pre-transplant serum sample was available were studied. 
      Graft survival during the first 3 post-transplant years was analyzed by 
      multivariable Cox regression. Pre-transplant predictors of DGF and influence of 
      DGF and pre-transplant HLA antibodies on biopsy-proven rejections in the first 3 
      post-transplant months were determined by multivariable logistic regression. 
      Donor age >/=50 years, simultaneous pre-transplant presence of HLA class I and II 
      antibodies, diabetes mellitus as cause of end-stage renal disease, cold ischemia 
      time >/=18 h, and time on dialysis >5 years were associated with increased risk of 
      DGF, while the risk was reduced if gender of donor or recipient was female or the 
      reason for death of donor was trauma. DGF alone doubled the risk for graft loss, 
      more due to impaired death-censored graft than patient survival. In DGF patients, 
      the risk of death-censored graft loss increased further if HLA antibodies (hazard 
      ratio HR=4.75, P < 0.001) or donor-specific HLA antibodies (DSA, HR=7.39, P < 
      0.001) were present pre-transplant. In the presence of HLA antibodies or DSA, the 
      incidence of biopsy-proven rejections, including antibody-mediated rejections, 
      increased significantly in patients with as well as without DGF. Recipients 
      without DGF and without biopsy-proven rejections during the first 3 months had 
      the highest fraction of patients with good kidney function at year 1, whereas 
      patients with both DGF and rejection showed the lowest rate of good kidney 
      function, especially when organs from >/=65-year-old donors were used. In this new 
      era of transplantation, besides non-immunological factors, also the 
      pre-transplant presence of HLA class I and II antibodies increase the risk of 
      DGF. Measures to prevent the strong negative impact of DGF on outcome are 
      necessary, especially during organ allocation for presensitized patients.
CI  - Copyright (c) 2020 Morath, Dohler, Kalble, Pego da Silva, Echterdiek, Schwenger, 
      Zivcic-Cosic, Katalinic, Kuypers, Benohr, Haubitz, Ziemann, Nitschke, Emmerich, 
      Pisarski, Karakizlis, Weimer, Ruhenstroth, Scherer, Tran, Mehrabi, Zeier and 
      Susal.
FAU - Morath, Christian
AU  - Morath C
AD  - Division of Nephrology, Heidelberg University Hospital, Heidelberg, Germany.
FAU - Dohler, Bernd
AU  - Dohler B
AD  - Institute of Immunology, Heidelberg University Hospital, Heidelberg, Germany.
FAU - Kalble, Florian
AU  - Kalble F
AD  - Division of Nephrology, Heidelberg University Hospital, Heidelberg, Germany.
FAU - Pego da Silva, Luiza
AU  - Pego da Silva L
AD  - Division of Nephrology, Heidelberg University Hospital, Heidelberg, Germany.
FAU - Echterdiek, Fabian
AU  - Echterdiek F
AD  - Department of Nephrology and Autoimmune Diseases, Transplantation Center, 
      Klinikum Stuttgart, Stuttgart, Germany.
FAU - Schwenger, Vedat
AU  - Schwenger V
AD  - Department of Nephrology and Autoimmune Diseases, Transplantation Center, 
      Klinikum Stuttgart, Stuttgart, Germany.
FAU - Zivcic-Cosic, Stela
AU  - Zivcic-Cosic S
AD  - Department of Nephrology, Dialysis and Kidney Transplantation, Department of 
      Internal Medicine, Clinical Hospital Center Rijeka, Faculty of Medicine, 
      University of Rijeka, Rijeka, Croatia.
FAU - Katalinic, Natasa
AU  - Katalinic N
AD  - Tissue Typing Laboratory, Clinical Institute of Transfusion Medicine, Clinical 
      Hospital Center Rijeka, Faculty of Medicine, University of Rijeka, Rijeka, 
      Croatia.
FAU - Kuypers, Dirk
AU  - Kuypers D
AD  - Department of Nephrology and Renal Transplantation, University Hospitals Leuven, 
      Leuven, Belgium.
FAU - Benohr, Peter
AU  - Benohr P
AD  - Department of Nephrology and Hypertension, Center for Internal Medicine and 
      Medical Clinic III, Klinikum Fulda, Fulda, Germany.
FAU - Haubitz, Marion
AU  - Haubitz M
AD  - Department of Nephrology and Hypertension, Center for Internal Medicine and 
      Medical Clinic III, Klinikum Fulda, Fulda, Germany.
FAU - Ziemann, Malte
AU  - Ziemann M
AD  - Institute of Transfusion Medicine, University Hospital of Schleswig-Holstein, 
      Lubeck, Germany.
FAU - Nitschke, Martin
AU  - Nitschke M
AD  - Medical Clinic 1, Transplantation Center, University of Lubeck, Lubeck, Germany.
FAU - Emmerich, Florian
AU  - Emmerich F
AD  - Institute for Transfusion Medicine and Gene Therapy, University Medical Center, 
      University of Freiburg, Freiburg, Germany.
FAU - Pisarski, Przemyslaw
AU  - Pisarski P
AD  - Department of General and Digestive Surgery, University Medical Centre Freiburg, 
      Freiburg, Germany.
FAU - Karakizlis, Hristos
AU  - Karakizlis H
AD  - Department of Internal Medicine, University of Giessen, Giessen, Germany.
FAU - Weimer, Rolf
AU  - Weimer R
AD  - Department of Internal Medicine, University of Giessen, Giessen, Germany.
FAU - Ruhenstroth, Andrea
AU  - Ruhenstroth A
AD  - Institute of Immunology, Heidelberg University Hospital, Heidelberg, Germany.
FAU - Scherer, Sabine
AU  - Scherer S
AD  - Institute of Immunology, Heidelberg University Hospital, Heidelberg, Germany.
FAU - Tran, Thuong Hien
AU  - Tran TH
AD  - Institute of Immunology, Heidelberg University Hospital, Heidelberg, Germany.
FAU - Mehrabi, Arianeb
AU  - Mehrabi A
AD  - Department of General and Transplant Surgery, University Hospital Heidelberg, 
      Heidelberg, Germany.
FAU - Zeier, Martin
AU  - Zeier M
AD  - Division of Nephrology, Heidelberg University Hospital, Heidelberg, Germany.
FAU - Susal, Caner
AU  - Susal C
AD  - Institute of Immunology, Heidelberg University Hospital, Heidelberg, Germany.
LA  - eng
PT  - Journal Article
PT  - Multicenter Study
DEP - 20200826
PL  - Switzerland
TA  - Front Immunol
JT  - Frontiers in immunology
JID - 101560960
RN  - 0 (Biomarkers)
RN  - 0 (HLA Antigens)
RN  - 0 (Isoantibodies)
SB  - IM
MH  - Adult
MH  - Aged
MH  - Biomarkers/blood
MH  - Delayed Graft Function/blood/diagnosis/*immunology/mortality
MH  - Europe
MH  - Female
MH  - Graft Rejection/blood/diagnosis/*immunology/mortality
MH  - Graft Survival
MH  - HLA Antigens/*immunology
MH  - Humans
MH  - Isoantibodies/*blood
MH  - Kidney Transplantation/*adverse effects/mortality
MH  - Male
MH  - Middle Aged
MH  - Prospective Studies
MH  - Risk Assessment
MH  - Risk Factors
MH  - Time Factors
MH  - Treatment Outcome
PMC - PMC7489336
OTO - NOTNLM
OT  - HLA antibodies
OT  - antibody-mediated rejections
OT  - biopsy-proven rejections
OT  - delayed graft function
OT  - donor-specific antibodies
OT  - renal transplantation
EDAT- 2020/09/29 06:00
MHDA- 2021/04/20 06:00
PMCR- 2020/01/01
CRDT- 2020/09/28 05:40
PHST- 2020/03/29 00:00 [received]
PHST- 2020/07/13 00:00 [accepted]
PHST- 2020/09/28 05:40 [entrez]
PHST- 2020/09/29 06:00 [pubmed]
PHST- 2021/04/20 06:00 [medline]
PHST- 2020/01/01 00:00 [pmc-release]
AID - 10.3389/fimmu.2020.01886 [doi]
PST - epublish
SO  - Front Immunol. 2020 Aug 26;11:1886. doi: 10.3389/fimmu.2020.01886. eCollection 
      2020.