PMID- 37931666
OWN - NLM
STAT- MEDLINE
DCOM- 20231216
LR  - 20240306
IS  - 1878-5492 (Electronic)
IS  - 0966-3274 (Linking)
VI  - 81
DP  - 2023 Dec
TI  - HLA B eplet mismatches in the context of delayed graft function and low 
      tacrolimus trough levels are risk factors influencing the generation of de novo 
      donor-specific antibodies and acute rejection in the early stage after kidney 
      transplantation.
PG  - 101955
LID - S0966-3274(23)00172-7 [pii]
LID - 10.1016/j.trim.2023.101955 [doi]
AB  - BACKGROUND: De novo donor-specific antibody (dnDSA) generation and acute 
      rejection (AR) are the main factors affecting long-term graft survival. This 
      study aims to investigate human leukocyte antigen (HLA) eplet mismatching (MM), 
      delayed graft function (DGF), and tacrolimus (TAC) trough levels on the 
      occurrence of dnDSA and AR in the early stages after kidney transplantation (KT). 
      METHODS: This retrospective study included 526 cases of deceased donation KT. The 
      effects of DGF, HLA eplet MM, and TAC trough levels on dnDSA and AR occurrence 
      were analyzed with logistic regression analysis. RESULTS: Multivariate logistic 
      regression analysis showed the independent risk factor of dnDSA generation was 
      HLA B eplet MM (OR: 1.201, 95% CI: 1.007-1.431, P = 0.041). The independent risk 
      factors of AR occurrence include DGF (OR: 4.045, 95% CI: 1.047-15.626, 
      P = 0.043), HLA B eplet MM (OR: 1.090, 95% CI: 1.000-1.187, P = 0.050), and TAC 
      trough levels at 12 months (OR: 0.750, 95% CI: 565-0.997, P = 0.048). HLA B eplet 
      MM combined with DGF and TAC trough levels at 12 months increased the predictive 
      value of dnDSA (AUC 0.735) and AR (AUC 0.730) occurrence. HLA B eplet MM > 9 and 
      TAC trough levels below 5.95 ng/mL at 12 months could increase the risk of early 
      AR occurrence. CONCLUSIONS: HLA B eplet MM, DGF, and TAC trough levels at 
      12 months after KT could affect the occurrence of dnDSA and AR in the early stage 
      of KT.
CI  - Copyright (c) 2023. Published by Elsevier B.V.
FAU - Gao, Shan
AU  - Gao S
AD  - Department of Renal Transplantation, Hospital of Nephrology, The First Affiliated 
      Hospital of Medical College, Xi'an Jiaotong University, Xi'an 710061, China.
FAU - Gong, Huilin
AU  - Gong H
AD  - Department of Renal Transplantation, Hospital of Nephrology, The First Affiliated 
      Hospital of Medical College, Xi'an Jiaotong University, Xi'an 710061, China.
FAU - Li, Meihe
AU  - Li M
AD  - Department of Renal Transplantation, Hospital of Nephrology, The First Affiliated 
      Hospital of Medical College, Xi'an Jiaotong University, Xi'an 710061, China.
FAU - Lan, Ping
AU  - Lan P
AD  - Department of Renal Transplantation, Hospital of Nephrology, The First Affiliated 
      Hospital of Medical College, Xi'an Jiaotong University, Xi'an 710061, China.
FAU - Zhang, Minyue
AU  - Zhang M
AD  - Department of Renal Transplantation, Hospital of Nephrology, The First Affiliated 
      Hospital of Medical College, Xi'an Jiaotong University, Xi'an 710061, China.
FAU - Kuang, Peidan
AU  - Kuang P
AD  - Department of Renal Transplantation, Hospital of Nephrology, The First Affiliated 
      Hospital of Medical College, Xi'an Jiaotong University, Xi'an 710061, China.
FAU - Zhang, Ying
AU  - Zhang Y
AD  - Department of Renal Transplantation, Hospital of Nephrology, The First Affiliated 
      Hospital of Medical College, Xi'an Jiaotong University, Xi'an 710061, China.
FAU - Hu, Xiaojun
AU  - Hu X
AD  - Department of Renal Transplantation, Hospital of Nephrology, The First Affiliated 
      Hospital of Medical College, Xi'an Jiaotong University, Xi'an 710061, China.
FAU - Ding, Chenguang
AU  - Ding C
AD  - Department of Renal Transplantation, Hospital of Nephrology, The First Affiliated 
      Hospital of Medical College, Xi'an Jiaotong University, Xi'an 710061, China.
FAU - Li, Yang
AU  - Li Y
AD  - Department of Renal Transplantation, Hospital of Nephrology, The First Affiliated 
      Hospital of Medical College, Xi'an Jiaotong University, Xi'an 710061, China.
FAU - Ding, Xiaoming
AU  - Ding X
AD  - Department of Renal Transplantation, Hospital of Nephrology, The First Affiliated 
      Hospital of Medical College, Xi'an Jiaotong University, Xi'an 710061, China.
FAU - Xue, Wujun
AU  - Xue W
AD  - Department of Renal Transplantation, Hospital of Nephrology, The First Affiliated 
      Hospital of Medical College, Xi'an Jiaotong University, Xi'an 710061, China. 
      Electronic address: xwujun126@mail.xjtu.edu.cn.
FAU - Zheng, Jin
AU  - Zheng J
AD  - Department of Renal Transplantation, Hospital of Nephrology, The First Affiliated 
      Hospital of Medical College, Xi'an Jiaotong University, Xi'an 710061, China. 
      Electronic address: jzheng@xjtu.edu.cn.
LA  - eng
PT  - Journal Article
DEP - 20231104
PL  - Netherlands
TA  - Transpl Immunol
JT  - Transplant immunology
JID - 9309923
RN  - WM0HAQ4WNM (Tacrolimus)
RN  - 0 (Antibodies)
RN  - 0 (HLA Antigens)
RN  - 0 (Histocompatibility Antigens Class II)
RN  - 0 (HLA-B Antigens)
SB  - IM
MH  - Humans
MH  - *Kidney Transplantation
MH  - Tacrolimus/therapeutic use
MH  - Retrospective Studies
MH  - Delayed Graft Function
MH  - Graft Rejection
MH  - Antibodies
MH  - HLA Antigens
MH  - Histocompatibility Antigens Class II
MH  - HLA-B Antigens
MH  - Graft Survival
MH  - Risk Factors
OTO - NOTNLM
OT  - Acute rejection
OT  - Delayed graft function
OT  - Eplet
OT  - Kidney transplantation
OT  - Tacrolimus
OT  - dnDSA
COIS- Declaration of Competing Interest The authors declare that there is no conflict 
      of interest.
EDAT- 2023/11/07 00:42
MHDA- 2023/12/17 09:41
CRDT- 2023/11/06 19:12
PHST- 2023/05/05 00:00 [received]
PHST- 2023/10/30 00:00 [revised]
PHST- 2023/11/01 00:00 [accepted]
PHST- 2023/12/17 09:41 [medline]
PHST- 2023/11/07 00:42 [pubmed]
PHST- 2023/11/06 19:12 [entrez]
AID - S0966-3274(23)00172-7 [pii]
AID - 10.1016/j.trim.2023.101955 [doi]
PST - ppublish
SO  - Transpl Immunol. 2023 Dec;81:101955. doi: 10.1016/j.trim.2023.101955. Epub 2023 
      Nov 4.