Risk Factors of Antibody-Mediated Rejection and Predictors of Outcome in Kidney Transplant Recipients

Yalcintas, Aysenur; Sayın, Burak; Turgut, Didem; Atay, Gökhan; Çolak, Turan; Haberal, Mehmet

doi:10.6002/ect.tond-tdtd2019.o1

Cited by 6 publications

(5 citation statements)

References 16 publications

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“…Humoral alloreactivity can now manifest itself at various time points after transplantation due to de novo generation of allo-and autoreactive (55) antibodies that mediate allograft dysfunction and fibrotic remodeling (56). Multiple immunologic and environment mechanisms, such as loss of Foxp3 + regulatory T cells (25), ischemia-reperfusion injury (57), presensitization due to prior environmental exposure (58), and infection (53), have been linked to AMR. As not all recipients develop AMR, a better understanding of immunologic mechanisms that contribute to this form of rejection may allow for the design of unique strategies to prevent it.…”

Section: Discussionmentioning

confidence: 99%

Eosinophils restrain humoral alloimmunity after lung transplantation

Mei,

Khalil,

Guo

et al. 2024

JCI Insight

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While the function of many leukocytes in transplant biology has been well defined, the role of eosinophils is controversial and remains poorly explored. Conflicting data exist regarding eosinophils’ role in alloimmunity. Due to their prevalence in the lung, and their defined role in other pulmonary pathologies such as asthma, we set out to explore the role of eosinophils in the long-term maintenance of the lung allograft. We noted that depletion of eosinophils results in the generation of donor-specific antibodies. Eosinophil depletion increased memory B cell, plasma cell, and antibody-secreting cell differentiation and resulted in de novo generation of follicular germinal centers. Germinal center formation depended on the expansion of CD4 + Foxp3 – Bcl6 + CXCR5 + PD-1 + T follicular helper (Tfh) cells, which increase in number after eosinophil depletion. Mechanistically, we demonstrate that eosinophils prevent Tfh cell generation by acting as the dominant source of IFN-γ in an established lung allograft, thus facilitating Th1 rather than Tfh polarization of naive CD4 + T cells. Our data thus describe what we believe is a unique and previously unknown role for eosinophils in maintaining allograft tolerance and suggest that indiscriminate administration of eosinophil-lytic corticosteroids for treatment of acute cellular rejection may inadvertently promote humoral alloimmunity.

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Section: Discussionmentioning

confidence: 99%

Eosinophils restrain humoral alloimmunity after lung transplantation

Mei,

Khalil,

Guo

et al. 2024

JCI Insight

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“…Consistent with these results, treatment modalities specific to antibody mediated rejection must be administered. The loss of graft due to AMR was found to be 15.3% in a study conducted by Yalçıntaş, et al [17]. In another study, seven (50%) patients lost their grafts [11].…”

Section: Discussionmentioning

confidence: 99%

Predictors of Graft Outcome in Renal Transplant Recipients with Antibody-Mediated Rejection

Ergün¹,

Meral²,

Kübra³

et al. 2021

Int J Transplant Res Med

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“…The loss of graft due to AMR was found to be 15.3% in a study conducted by Yalçıntaş et al [16]. In another study, seven (50%) patients lost their grafts [11].…”

Section: Tablementioning

confidence: 90%

Predictors of graft outcome in renal transplant recipients with antibody-mediated rejection

Parmaksız

Meşe

Yadigar

et al. 2021

Ukr. J. Nephrol. and Dial.

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Abstract. Active and chronic antibody-mediated rejection (ABMR) is a common cause of graft failure. Prognostic markers of this complication are not well defined. We aimed to find out the demographic, histopathological and clinical characteristics of transplant recipients who developed ABMR and evaluate the impact of these features, and anti-rejection treatment modalities on graft survival. Methods. Thirty-two patients who developed ABMR (22 male; mean age 40.59±12.52 years) were included in this study. Data were evaluated retrospectively and graft survival was analyzed. All transplant biopsies were evaluated according to Banff's 2013 classification. Results. Among the 32 cases, 26 were transplanted from living donors. Mean serum creatinine at the time of biopsy was 1.99 ±0.09 mg/dL. Proteinuria was 1566.06±353.92 mg/day at the time of biopsy. The need for hemodialysis was significantly related with initial creatinine (p = 0.003); creatinine after three months (p < 0.001) and final creatinine (p < 0.001) as well as initial proteinuria (p = 0.005); proteinuria after three months (p < 0.001) and final proteinuria (p < 0.001). 6 cases showed diffuse C4d positivity, 26 cases showed focal c4d positivity. Five of 6 patients with diffuse C4d staining in renal biopsy were hemodialyzed at first and third months despite anti-rejection therapy (p=0.029 and 0.041, respectively). Mean survival time was 1654.67±220.40 (95% CI 1222.68-2086.66) days for focal staining C4d cases and 366.16±36.44 (95% CI 294.73-437.60) days for diffuse staining C4d cases. The difference was statistically significant (p=0.012). Two of the patients died, 15 experienced graft loss and 17 survived with functioning grafts. Mean survival time between anti-rejection treatment modalities showed no statistical significance (p=0.15) Conclusions. Serum creatinine, proteinuria at the time of biopsy, diffuse peritubular C4d staining were significantly associated with graft survival. Early diagnosis is important to improve success in the treatment of ABMR and graft survival

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Risk Factors of Antibody-Mediated Rejection and Predictors of Outcome in Kidney Transplant Recipients

Cited by 6 publications

References 16 publications

Eosinophils restrain humoral alloimmunity after lung transplantation

Eosinophils restrain humoral alloimmunity after lung transplantation

Predictors of Graft Outcome in Renal Transplant Recipients with Antibody-Mediated Rejection

Predictors of graft outcome in renal transplant recipients with antibody-mediated rejection

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