Pre‐existing donor‐specific antibodies are detrimental to kidney allograft only when persistent after transplantation |
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| Authors: | Sophie Caillard Camille Becmeur Gabriela Gautier‐Vargas Jerome Olagne Clotilde Muller Noelle Cognard Peggy Perrin Laura Braun Francoise Heibel Francois Lefebre Veronique Renner Christian Gachet Bruno Moulin Anne Parissiadis |
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| Institution: | 1. Department of Nephrology, Division of Renal Transplantation, University Hospital of Strasbourg, Strasbourg, France;2. Department of Nephropathology, University Hospital of Strasbourg, Strasbourg, France;3. Public Health Department, University Hospital of Strasbourg, Strasbourg, France;4. Histocompatibility Laboratory, UMR_S949 Inserm, Strasbourg, France |
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| Abstract: | Donor‐specific antibodies (DSA) increase the risk of allograft rejection and graft failure. They may be present before transplant or develop de novo after transplantation. Here, we studied the evolution of preformed DSA and their impact on graft outcome in kidney transplant recipients. Using the Luminex Single Antigen assay, we analyzed the sera on the day of transplantation of 239 patients who received a kidney transplant. Thirty‐seven patients (15.5%) had pre‐existing DSA detected the day of transplantation. After 5 years, the pre‐existing DSA disappeared in 22 patients whereas they persisted in 12. Variables associated with DSA persistence were age <50 years (P = 0.009), a history of previous transplantation (P = 0.039), the presence of class II DSA (P = 0.009), an MFI of preformed DSA >3500 (P < 0.001), and the presence of two or more DSA (P < 0.001). DSA persistence was associated with a higher risk of graft loss and antibody‐mediated rejection. Previously undetected preformed DSA are deleterious to graft survival only when they persist after transplantation. |
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| Keywords: | antibody‐mediated rejection donor‐specific antibody graft survival kidney transplantation |
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