Impact of persistent preformed and de novo donor-specific antibodies detected at 1 year after kidney transplantation on long-term graft survival in Japan: a retrospective study

Fujiyama, Nobuhiro; Satoh, Shigeru; Saito, Mitsuru; Numakura, Kazuyuki; Inoue, Takamitsu; Yamamoto, Ryuhei; Saito, Takuro; Kanda, Sohei; Narita, Shintaro; Mitobe, Yoko; Habuchi, Tomonori

doi:10.1007/s10157-019-01780-z

Cited by 4 publications

(3 citation statements)

References 30 publications

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“…This might imply that current, circulating DSAs are more essential in the prediction of the renal allograft compared to resolved DSAs. A similar conclusion was reached in studies involving not only adult renal transplant recipients but also patients after other solid organ transplantation such as heart, lung, or intestine [27][28][29][30]. A history of previous transplantation is independently associated with the persistence of preformed DSAs.…”

Section: Discussionsupporting

confidence: 65%

Impact of Resolved Preformed, Persistent Preformed, and De Novo Anti-HLA Donor-Specific Antibodies in Kidney Transplant Recipients on Long-Term Renal Graft Outcomes

Gniewkiewicz

Czerwińska

Zielniok

et al. 2023

JCM

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The post-transplant evolution of antihuman leukocyte antigen donor-specific antibodies (anti-HLA DSAs) includes three clinical patterns: resolved preformed DSAs, persistent preformed DSAs, and de novo DSAs. The aim of this retrospective study was to analyze the impact of resolved preformed, persistent preformed, and de novo anti-HLA-A, -B, and -DR DSAs in kidney transplant recipients on long-term renal allograft outcomes. This is a post hoc analysis of the study conducted in our transplant center. One hundred eight kidney transplant recipients were included in the study. Patients were followed for a minimum of 24 months after allograft biopsy, which was performed 3 to 24 months after kidney transplantation. The identification of persistent preformed DSAs at the time of biopsy was the most significant predictor of the combined endpoint of the study (>30% decline in estimated glomerular filtration rate or death-censored graft loss; HR = 5.96, 95% CI 2.041–17.431, p = 0.0011), followed by the occurrence of de novo DSAs (HR = 4.48, 95% CI 1.483–13.520, p = 0.0079). No increased risk was observed in patients with resolved preformed DSAs (HR = 1.10, 95% CI 0.139–8.676, p = 0.9305). Patients with resolved preformed DSAs have similar graft prognoses as patients without DSAs, therefore, the persistence of preformed DSAs and development of de novo DSAs are associated with inferior long-term allograft outcomes.

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Section: Discussionsupporting

confidence: 65%

Impact of Resolved Preformed, Persistent Preformed, and De Novo Anti-HLA Donor-Specific Antibodies in Kidney Transplant Recipients on Long-Term Renal Graft Outcomes

Gniewkiewicz

Czerwińska

Zielniok

et al. 2023

JCM

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“…Donor-specific antibody was retrospectively measured in the sera 1-year after transplantation stored until use using Luminex-based SAB kits (LABSCreen PRA and LABSCreen Single Antigen, Thermo Fisher Scientific, Waltham, MA). Positive evaluations were made as previously described 45 . Indication biopsy was performed when patients had an unexplained rise in serum creatinine (>25% from baseline value) during the follow-up period, but the presence of TLTs in these samples was not assessed in this study.…”

Section: Methodsmentioning

confidence: 99%

“…Positive evaluations were made as previously described. 45 Indication biopsy was performed when patients had an unexplained rise in serum creatinine (.25% from baseline value) during the follow-up period, but the presence of TLTs in these samples was not assessed in this study. Kidney function was measured as the eGFR using the CKD Epidemiology Collaboration formula for the Japanese population.…”

Section: Study Population and Protocol Biopsy Sample Acquisitionmentioning

confidence: 99%

Advanced Tertiary Lymphoid Tissues in Protocol Biopsies are Associated with Progressive Graft Dysfunction in Kidney Transplant Recipients

Lee

Sato

Saito

et al. 2022

JASN

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Background: Tertiary lymphoid tissues (TLTs) are ectopic lymphoid tissues found in chronically inflamed organs. Although studies have documented TLT formation in transplanted kidneys, the clinical relevance of these TLTs remains controversial. We examined the impacts of TLTs on future graft function using our histological TLT maturity stages and the association between TLTs and Banff pathologic scores. We also analyzed the risk factors for the development of TLTs Methods: Serial protocol biopsy samples (0-hour, 1-, 6-, and 12-months) without rejection were retrospectively analyzed from 214 patients who underwent living donor kidney transplantation. TLTs were defined as lymphocyte aggregates with signs of proliferation and their stages were determined by the absence (stage I) or presence (stage II) of follicular dendritic cells. Results: Only 4% of patients exhibited TLTs at the 0-hour biopsy. Prevalence increased to almost 50% at the 1-month biopsy and then slightly further for 12 months. The proportion of advanced stage II TLTs increased gradually, reaching 19% at the 12-month biopsy. Presence of stage II TLTs was associated with higher risk of renal function decline after transplantation compared to patients with no TLT or stage I TLTs. Stage II TLTs were associated with more severe tubulitis and interstitial fibrosis/tubular atrophy at 12 months and predicted poorer graft function independently from the degree of interstitial inflammation. Pre-transplantation rituximab treatment dramatically attenuated the development of stage II TLTs. Conclusions: TLTs are commonly found in clinically stable transplanted kidneys. Advanced stage II TLTs are associated with progressive graft dysfunction, independent of interstitial inflammation

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Living Kidney Recipient Outcomes

Calderon

Mathur

Merion

2022

Living Kidney Donation

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Impact of persistent preformed and de novo donor-specific antibodies detected at 1 year after kidney transplantation on long-term graft survival in Japan: a retrospective study

Cited by 4 publications

References 30 publications

Impact of Resolved Preformed, Persistent Preformed, and De Novo Anti-HLA Donor-Specific Antibodies in Kidney Transplant Recipients on Long-Term Renal Graft Outcomes

Impact of Resolved Preformed, Persistent Preformed, and De Novo Anti-HLA Donor-Specific Antibodies in Kidney Transplant Recipients on Long-Term Renal Graft Outcomes

Advanced Tertiary Lymphoid Tissues in Protocol Biopsies are Associated with Progressive Graft Dysfunction in Kidney Transplant Recipients

Living Kidney Recipient Outcomes

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