PMID- 35257893
OWN - NLM
STAT- MEDLINE
DCOM- 20220524
LR  - 20220603
IS  - 1878-5492 (Electronic)
IS  - 0966-3274 (Linking)
VI  - 72
DP  - 2022 Jun
TI  - Effect of C1q-binding donor-specific anti-HLA antibodies on the clinical outcomes 
      of patients after renal transplantation: A systematic review and meta-analysis.
PG  - 101566
LID - S0966-3274(22)00040-5 [pii]
LID - 10.1016/j.trim.2022.101566 [doi]
AB  - BACKGROUND: Complement-binding donor-specific human leukocyte antigen (HLA) 
      antibodies in kidney recipients have been associated with a higher risk of 
      allograft rejection and loss. The objective of this meta-analysis was to 
      investigate the correlation between C1q-binding donor-specific antibodies (DSAs) 
      and clinical outcomes in kidney transplantation (KT) recipients. METHODS: We 
      conducted systematic searches in the PubMed, EMBASE, and the Cochrane Library 
      databases to identify all studies since inception to August 2021 that compared 
      clinical outcomes between C1q + DSA and C1q-DSA patients who underwent KT. Data 
      were independently extracted by two reviewers who assessed the risk of bias. Data 
      were summarized with fixed effects or random effects models according to 
      heterogeneity. We assessed clinical outcomes including graft loss, rejection, 
      delayed graft function (DGF), and all-cause patient death. RESULTS: Twenty-six 
      studies with a total of 1337 patients were included: 485 with C1q-binding DSAs, 
      and 850 without C1q-binding DSAs. Compared with the C1q-DSA group, the C1q + DSA 
      group had significant increases in antibody-mediated rejection (AMR) (relative 
      risk [RR] = 2.09, 95% confidence interval [CI], 1.53-2.86; P < 0.00001), graft 
      loss (RR = 2.40, 95% CI, 1.66-3.47; P < 0.00001), and death (RR = 3.13, 95% CI, 
      1.06-9.23; P = 0.04). The C1q + DSA and C1q-DSA groups did not show significant 
      differences in T-cell-mediated rejection, acute rejection, acute cellular 
      rejection, mixed rejection, or DGF. CONCLUSION: The findings of this systematic 
      review suggest that C1q + DSA KT have a higher risk of AMR, graft loss, and death 
      compared with C1q-DSA patients. Monitoring C1q-binding DSAs allows risk 
      stratification of recipients and guides physician management.
CI  - Copyright (c) 2022 Elsevier B.V. All rights reserved.
FAU - Kang, Zhong-Yu
AU  - Kang ZY
AD  - Department of Blood Transfusion, Tianjin First Central Hospital, 24 Fukang Road, 
      Tianjin, Nankai, China.
FAU - Liu, Chun
AU  - Liu C
AD  - Department of Blood Transfusion, Tianjin First Central Hospital, 24 Fukang Road, 
      Tianjin, Nankai, China.
FAU - Liu, Wei
AU  - Liu W
AD  - Department of Blood Transfusion, Tianjin First Central Hospital, 24 Fukang Road, 
      Tianjin, Nankai, China.
FAU - Li, Dai-Hong
AU  - Li DH
AD  - Department of Blood Transfusion, Tianjin First Central Hospital, 24 Fukang Road, 
      Tianjin, Nankai, China. Electronic address: ldh_hla@126.com.
LA  - eng
PT  - Journal Article
PT  - Meta-Analysis
PT  - Review
PT  - Systematic Review
DEP - 20220304
PL  - Netherlands
TA  - Transpl Immunol
JT  - Transplant immunology
JID - 9309923
RN  - 0 (Antibodies)
RN  - 0 (HLA Antigens)
RN  - 0 (Isoantibodies)
RN  - 80295-33-6 (Complement C1q)
SB  - IM
MH  - Antibodies
MH  - Complement C1q
MH  - Graft Rejection
MH  - Graft Survival
MH  - HLA Antigens
MH  - Humans
MH  - Isoantibodies
MH  - *Kidney Transplantation/adverse effects
MH  - Retrospective Studies
MH  - Tissue Donors
OTO - NOTNLM
OT  - Antibody-mediated rejection
OT  - C1q-binding antibodies
OT  - Graft loss
OT  - Human leukocyte antigen
OT  - KT
OT  - meta-analysis
EDAT- 2022/03/09 06:00
MHDA- 2022/05/25 06:00
CRDT- 2022/03/08 08:45
PHST- 2022/01/27 00:00 [received]
PHST- 2022/02/27 00:00 [revised]
PHST- 2022/02/28 00:00 [accepted]
PHST- 2022/03/09 06:00 [pubmed]
PHST- 2022/05/25 06:00 [medline]
PHST- 2022/03/08 08:45 [entrez]
AID - S0966-3274(22)00040-5 [pii]
AID - 10.1016/j.trim.2022.101566 [doi]
PST - ppublish
SO  - Transpl Immunol. 2022 Jun;72:101566. doi: 10.1016/j.trim.2022.101566. Epub 2022 
      Mar 4.