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Molecular and Experimental Biology in Medicine, Vol. 3 No. 1, 2020.

Original scientific paper

https://doi.org/10.33602/mebm.3.1.3

LONG-TERM SURVIVAL OF THE TRANSPLANTED KIDNEY AND THE CLINICAL RELEVANCE OF DONOR-SPECIFIC ANTIBODIES

Eva Svobodova ; Department of Immunogenetics, IKEM, Prague, Czech Republic
Antonij Slavcev orcid id orcid.org/0000-0002-6154-9131 ; Department of Immunogenetics, IKEM, Prague, Czech Republic
Janka Slatinska ; Department of Nephrology, IKEM, Prague, Czech Republic
Sarka Valhova ; Department of Immunogenetics, IKEM, Prague, Czech Republic
Eva Honsova ; Department of Clinical & Transplantation Pathology, IKEM, Prague, Czech Republic
Jelena Skibova ; Unit of Medical Statistics, IKEM, Prague, Czech Republic
Ilja Striz orcid id orcid.org/0000-0001-9269-5652 ; Department of Clinical & Transplantation Immunology, IKEM, Prague, Czech Republic
Ondrej Viklicky ; Department of Nephrology, IKEM, Prague, Czech Republic

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Abstract

The aim of our study was to evaluate the relevance of donor-specific antibodies (DSA) as defined by solid-phase single-antigen (SA) assays for predicting long-term graft survival after kidney transplantation. Sera from 132 kidney transplant recipients were retrospectively tested before, 3, 6 and 12 months after transplantation. The incidence of rejection and graft survival was followed up for 7 years. We found 29 episodes of acute cellular rejection (CR), 21 cases of antibody-mediated rejection (AMR) and 18 graft failures due to immunological reasons. Pre-transplant DSA and DSA three months after transplantation correlated with an increased rate of AMR and impaired graft function. After the fourth year, recipients with persistent DSA were at a higher risk of graft failure (p = 0.0317). Antibody specificity was prevailingly to HLA class I antigens (66.6% DSA, 75% non-DSA). During the first year after transplantation, the number of patients with non-DSA decreased (30.3% to 10.7%), while, due to de novo production of antibodies, the number of DSA positive patients remained constant. Conclusion: Detection of antibodies to HLA antigens using solid-phase assays, especially single-antigen bead technology before and three months after transplantation is predictive for increased incidence of antibody-mediated rejection and impaired long-term kidney graft survival.

Keywords

kidney transplantation; antibodies; rejection; HLA; crossmatch

Hrčak ID:

238477

URI

https://hrcak.srce.hr/238477

Publication date:

1.6.2020.

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