306.5: A Prospective Study of Donor-specific Anti-HLA Antibody Monitoring in Pancreas Transplantation

Perosa, Marcelo; Vidigal, Ana Cláudia; Danziere, Fernanda; Marco, Renato de; Malheiros, Denise Maria Avancini Costa; Branez, Juan; Watanabe, Celia; Paredes, Marcelo; Alvim, Leon

doi:10.1097/01.tp.0000804388.98141.6e

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“…На сегодняшний день опубликовано сравнительно мало работ, посвященных влиянию выявления повышенного уровня антител к антигенам системы человеческих лейкоцитарных антигенов (анти-HLA-антител) на исходы трансплантации ПЖ. Согласно данным одних ученых, результаты лечения реципиентов с предсуществующими анти-HLA-антителами хуже, чем у несенсибилизированных пациентов, а образование de novo анти-HLA-антител после трансплантации повышает частоту утраты трансплантатов [1][2][3][6][7][8][9]. Согласно данным других исследователей, выявление анти-HLA-антител статистически значимо не влияет на исходы трансплантации ПЖ, в том числе и в виде сочетанной трансплантации с почкой [10,11].…”

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Significance of pretransplant and de novo anti-HLA antibody detection after simultaneous pancreas-kidney transplantation

Дмитриев¹,

Borovkova²,

Shchelykalina

et al. 2022

Transplantologiâ (Mosk.)

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Introduction. Nowadays, there are few studies concerning assessment of the clinical significance of determining the level of pretransplant and de novo anti-HLA antibodies in patients after simultaneous pancreas-kidney transplantation.Aim. The study of the incidence, timing of formation and specificity of pretransplant and de novo anti-HLA antibodies in patients after simultaneous pancreas-kidney transplantation.Material and methods. We conducted a prospective and retrospective research to study the incidence, timing of formation and specificity of pretransplant and de novo anti-HLA antibodies in 55 patients after simultaneous pancreas-kidney transplantation performed at the N.V. Sklifosovsky Research Institute for Emergency Medicine from 2008 to 2022.Results. There were 4 patients with preformed anti-HLA antibodies (7%). The formation of de novo anti-HLA antibodies after simultaneous pancreas-kidney transplantation was observed in 17 patients (31%). There were 5 patients with antiHLA class I, 3 patients with anti-HLA class II, 3 patients with anti-HLA class I and II, 5 patients with anti-MICA and 1 patient with both classes of anti-HLA and anti-MICA. The formation of de novo anti-HLA antibodies significantly increased the incidence of acute rejection (47% compared with 13%, p=0.014).Conclusion. The frequency of pretransplant and de novo anti-HLA antibody detection in the recipients at our Center is comparable to published data from other transplant centers. We obtained evidence that the formation of de novo antiHLA antibodies increases the incidence of acute rejection after simultaneous pancreas-kidney transplantation.

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