In-Depth Analysis of Anti-HLA Antibodies Using C1q Assay

Zielińska, Hanna; Zieliński, Maciej; Dębska-Zielkowska, Joanna; Dukat-Mazurek, Anna; Moszkowska, Grażyna; Lewandowska, Dorota; Dębska‐Ślizień, Alicja; Trzonkowski, Piotr

doi:10.1016/j.transproceed.2022.02.054

Cited by 1 publication

(1 citation statement)

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“…34 A 2022 meta-analysis of 26 studies estimated that patients with C1q + DSA had a 2.4 times increased risk of graft failure (95% CI 1.66-3.47, p < .00001) and a 3.13 times increased risk of death (95% CI 1.06-9.23, p = .04) compared to those with C1q-DSA. 35 While C1q testing is available for clinical practice, its overall utility remains controversial due to the strong association between C1q binding activity and MFI 36 or antibody titer, 37 and studies suggesting that C1q binding activity measurements can be affected by diluting or concentrating the serum samples. 38 DSA detection is critical to diagnosis of ABMR but its use as a screening test has certain limitations.…”

Section: Donor-s Pecific Antibodie Smentioning

confidence: 99%

Immune monitoring in pediatric kidney transplant

Laroche,

Engen

2024

Pediatric Transplantation

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BackgroundLong‐term outcomes in pediatric kidney transplantation remain suboptimal, largely related to chronic rejection. Creatinine is a late marker of renal injury, and more sensitive, early markers of allograft injury are an active area of current research.MethodsThis is an educational review summarizing existing strategies for monitoring for rejection in kidney transplant recipients.ResultsWe summarize supporting currently available clinical tests, including surveillance biopsy, donor specific antibodies, and donor‐derived cell free DNA, as well as the potential limitations of these studies. In addition, we review the current avenues of active research, including transcriptomics, proteomics, metabolomics, and torque tenovirus levels.ConclusionAdvancing the use of noninvasive immune monitoring will depend on well‐designed multicenter trials that include patients with stable graft function, include biopsy results on all patients, and can demonstrate both association with a patient‐relevant clinical endpoint such as graft survival or change in glomerular filtration rate and a potential timepoint for intervention.

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