PMID- 36556358
OWN - NLM
STAT- PubMed-not-MEDLINE
LR  - 20230308
IS  - 2075-1729 (Print)
IS  - 2075-1729 (Electronic)
IS  - 2075-1729 (Linking)
VI  - 12
IP  - 12
DP  - 2022 Nov 29
TI  - Low Incidence of Acute Antibody-Mediated Rejection after HLA Desensitization in 
      Living Donor Kidney Transplant Recipients.
LID - 10.3390/life12121993 [doi]
LID - 1993
AB  - Desensitization allows the performance of human leukocyte antigen 
      (HLA)-incompatible transplants. However, the incidence of acute rejection (AR) is 
      high. This study aims to analyze the incidence of AR after transplantation with 
      HLA-incompatible living donors in patients who underwent desensitization. 
      Patients were immunosuppressed with tacrolimus, mycophenolic acid derivatives, 
      and steroids after being desensitized with rituximab, plasma exchange, and/or 
      immunoadsorption with specific cytomegalovirus immunoglobulins. A negative 
      complement-dependent cytotoxicity or flow cytometry crossmatch and a 
      donor-specific antibody titer < 1000 mean fluorescence intensity (MFI) were used 
      to determine desensitization efficacy. A total of 36 patients underwent 
      desensitization, and 27 (75%) were transplanted. After a follow-up of 58 +/- 58 
      months (Min-Max: 0.13-169.5), five episodes of AR occurred: two antibody-mediated 
      and three T-cell-mediated. No differences were found in baseline calculated 
      panel-reactive antibodies (cPRA), class I or II MFI, number of antibodies, or 
      Relative Intensity Scale (RIS) between AR and non-AR patients. Patients with 
      antibody-mediated AR had higher cPRA (NS), MFI class I (p = 0.07) and class II (p 
      = 0.006), and RIS (p = 0.01). The two patients with antibody-mediated AR and one 
      patient with T-cell-mediated AR lost their grafts. In conclusion, the incidence 
      of acute antibody-mediated rejection after desensitization was 7.4%, which 
      occurred early post-transplantation in patients with high MFI and was associated 
      with early graft loss.
FAU - Fernandez Rivera, Constantino
AU  - Fernandez Rivera C
AUID- ORCID: 0000-0003-2801-6752
AD  - Nephrology Service, A Coruna University Hospital Complex, 15006 A Coruna, Spain.
FAU - Rodriguez Magarinos, Catuxa
AU  - Rodriguez Magarinos C
AD  - Nephrology Service, A Coruna University Hospital Complex, 15006 A Coruna, Spain.
FAU - Calvo Rodriguez, Maria
AU  - Calvo Rodriguez M
AD  - Nephrology Service, A Coruna University Hospital Complex, 15006 A Coruna, Spain.
FAU - Ferreiro Hermida, Tamara
AU  - Ferreiro Hermida T
AD  - Nephrology Service, A Coruna University Hospital Complex, 15006 A Coruna, Spain.
FAU - Blanco Pardo, Marta
AU  - Blanco Pardo M
AD  - Nephrology Service, A Coruna University Hospital Complex, 15006 A Coruna, Spain.
FAU - Lopez Muniz, Andres
AU  - Lopez Muniz A
AD  - Nephrology Service, A Coruna University Hospital Complex, 15006 A Coruna, Spain.
FAU - Erraez Guerrero, Sara
AU  - Erraez Guerrero S
AD  - Nephrology Service, A Coruna University Hospital Complex, 15006 A Coruna, Spain.
FAU - Garcia Gago, Leticia
AU  - Garcia Gago L
AD  - Nephrology Service, A Coruna University Hospital Complex, 15006 A Coruna, Spain.
FAU - Alonso Hernandez, Angel
AU  - Alonso Hernandez A
AD  - Nephrology Service, A Coruna University Hospital Complex, 15006 A Coruna, Spain.
LA  - eng
PT  - Journal Article
DEP - 20221129
PL  - Switzerland
TA  - Life (Basel)
JT  - Life (Basel, Switzerland)
JID - 101580444
PMC - PMC9781496
OTO - NOTNLM
OT  - HLA desensitization
OT  - acute rejection
OT  - immunoglobulins
OT  - plasma exchange
OT  - rituximab
COIS- The corresponding author has received remuneration for having participated in 
      various meetings: advisory councils, expert gatherings, and teaching courses from 
      Alexion, Novartis, Astelas, Chiesi, and Biotest. The rest of the authors confirm 
      that they have no conflict of interest in the preparation of this manuscript.
EDAT- 2022/12/24 06:00
MHDA- 2022/12/24 06:01
PMCR- 2022/11/29
CRDT- 2022/12/23 01:40
PHST- 2022/10/17 00:00 [received]
PHST- 2022/11/18 00:00 [revised]
PHST- 2022/11/21 00:00 [accepted]
PHST- 2022/12/23 01:40 [entrez]
PHST- 2022/12/24 06:00 [pubmed]
PHST- 2022/12/24 06:01 [medline]
PHST- 2022/11/29 00:00 [pmc-release]
AID - life12121993 [pii]
AID - life-12-01993 [pii]
AID - 10.3390/life12121993 [doi]
PST - epublish
SO  - Life (Basel). 2022 Nov 29;12(12):1993. doi: 10.3390/life12121993.