Preformed C1q-binding Donor-specific Anti-HLA Antibodies and Graft Function After Kidney Transplantation

Yasuhiro Okabe, H. Noguchi, K. Miyamoto, Keizo Kaku, akihiro tsuchimoto, K. Masutani, Masafumi Nakamura

Research output: Contribution to journalArticle

Abstract

Background: De novo complement-binding donor-specific anti-human leukocyte antigen antibodies (DSAs) are reportedly associated with an increased risk of kidney graft failure, but there is little information on preformed complement-binding DSAs. This study investigated the correlation between preformed C1q-binding DSAs and medium-term outcomes in kidney transplantation (KT). Methods: We retrospectively studied 44 pretransplant DSA-positive patients, including 36 patients who underwent KT between April 2010 and October 2016. There were 17 patients with C1q-binding DSAs and 27 patients without C1q-binding DSAs. Clinical variables were examined in the 2 groups. Results: Patients with C1q-binding DSAs had significantly higher blood transfusion history (53.0% vs 18.6%; P =.0174), complement-dependent cytotoxicity crossmatch (CDC-XM)-positivity (29.4% vs 0%; P =.0012), and DSA median fluorescence intensity (MFI) (10,974 vs 2764; P =.0009). Among patients who were not excluded for CDC-XM-positivity and underwent KT, there was no significant difference in cumulative biopsy-proven acute rejection rate (32.5% vs 33.5%; P =.8354), cumulative graft survival, and 3-month and 12-month protocol biopsy results between patients with and without C1q-binding DSAs. Although patients with C1q-binding DSAs showed a higher incidence of delayed graft function (54.6% vs 20.0%; P =.0419), multivariate logistic regression showed that DSA MFI (P =.0124), but not C1q-binding DSAs (P =.2377), was an independent risk factor for delayed graft function. Conclusions: In patients with CDC-XM-negativity, preformed C1q-binding DSAs were not associated with incidence of antibody-mediated rejection and medium-term graft survival after KT. C1q-binding DSAs were highly correlated with DSA MFI and CDC-XM-positivity.

Original languageEnglish
Pages (from-to)3460-3466
Number of pages7
JournalTransplantation Proceedings
Volume50
Issue number10
DOIs
Publication statusPublished - Dec 1 2018

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Kidney Transplantation
Anti-Idiotypic Antibodies
Tissue Donors
Transplants
Delayed Graft Function
Fluorescence
Graft Survival
Biopsy
Antibodies
Incidence
HLA Antigens
Blood Transfusion
Renal Insufficiency
Logistic Models
History

All Science Journal Classification (ASJC) codes

  • Surgery
  • Transplantation

Cite this

Preformed C1q-binding Donor-specific Anti-HLA Antibodies and Graft Function After Kidney Transplantation. / Okabe, Yasuhiro; Noguchi, H.; Miyamoto, K.; Kaku, Keizo; tsuchimoto, akihiro; Masutani, K.; Nakamura, Masafumi.

In: Transplantation Proceedings, Vol. 50, No. 10, 01.12.2018, p. 3460-3466.

Research output: Contribution to journalArticle

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title = "Preformed C1q-binding Donor-specific Anti-HLA Antibodies and Graft Function After Kidney Transplantation",
abstract = "Background: De novo complement-binding donor-specific anti-human leukocyte antigen antibodies (DSAs) are reportedly associated with an increased risk of kidney graft failure, but there is little information on preformed complement-binding DSAs. This study investigated the correlation between preformed C1q-binding DSAs and medium-term outcomes in kidney transplantation (KT). Methods: We retrospectively studied 44 pretransplant DSA-positive patients, including 36 patients who underwent KT between April 2010 and October 2016. There were 17 patients with C1q-binding DSAs and 27 patients without C1q-binding DSAs. Clinical variables were examined in the 2 groups. Results: Patients with C1q-binding DSAs had significantly higher blood transfusion history (53.0{\%} vs 18.6{\%}; P =.0174), complement-dependent cytotoxicity crossmatch (CDC-XM)-positivity (29.4{\%} vs 0{\%}; P =.0012), and DSA median fluorescence intensity (MFI) (10,974 vs 2764; P =.0009). Among patients who were not excluded for CDC-XM-positivity and underwent KT, there was no significant difference in cumulative biopsy-proven acute rejection rate (32.5{\%} vs 33.5{\%}; P =.8354), cumulative graft survival, and 3-month and 12-month protocol biopsy results between patients with and without C1q-binding DSAs. Although patients with C1q-binding DSAs showed a higher incidence of delayed graft function (54.6{\%} vs 20.0{\%}; P =.0419), multivariate logistic regression showed that DSA MFI (P =.0124), but not C1q-binding DSAs (P =.2377), was an independent risk factor for delayed graft function. Conclusions: In patients with CDC-XM-negativity, preformed C1q-binding DSAs were not associated with incidence of antibody-mediated rejection and medium-term graft survival after KT. C1q-binding DSAs were highly correlated with DSA MFI and CDC-XM-positivity.",
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T1 - Preformed C1q-binding Donor-specific Anti-HLA Antibodies and Graft Function After Kidney Transplantation

AU - Okabe, Yasuhiro

AU - Noguchi, H.

AU - Miyamoto, K.

AU - Kaku, Keizo

AU - tsuchimoto, akihiro

AU - Masutani, K.

AU - Nakamura, Masafumi

PY - 2018/12/1

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N2 - Background: De novo complement-binding donor-specific anti-human leukocyte antigen antibodies (DSAs) are reportedly associated with an increased risk of kidney graft failure, but there is little information on preformed complement-binding DSAs. This study investigated the correlation between preformed C1q-binding DSAs and medium-term outcomes in kidney transplantation (KT). Methods: We retrospectively studied 44 pretransplant DSA-positive patients, including 36 patients who underwent KT between April 2010 and October 2016. There were 17 patients with C1q-binding DSAs and 27 patients without C1q-binding DSAs. Clinical variables were examined in the 2 groups. Results: Patients with C1q-binding DSAs had significantly higher blood transfusion history (53.0% vs 18.6%; P =.0174), complement-dependent cytotoxicity crossmatch (CDC-XM)-positivity (29.4% vs 0%; P =.0012), and DSA median fluorescence intensity (MFI) (10,974 vs 2764; P =.0009). Among patients who were not excluded for CDC-XM-positivity and underwent KT, there was no significant difference in cumulative biopsy-proven acute rejection rate (32.5% vs 33.5%; P =.8354), cumulative graft survival, and 3-month and 12-month protocol biopsy results between patients with and without C1q-binding DSAs. Although patients with C1q-binding DSAs showed a higher incidence of delayed graft function (54.6% vs 20.0%; P =.0419), multivariate logistic regression showed that DSA MFI (P =.0124), but not C1q-binding DSAs (P =.2377), was an independent risk factor for delayed graft function. Conclusions: In patients with CDC-XM-negativity, preformed C1q-binding DSAs were not associated with incidence of antibody-mediated rejection and medium-term graft survival after KT. C1q-binding DSAs were highly correlated with DSA MFI and CDC-XM-positivity.

AB - Background: De novo complement-binding donor-specific anti-human leukocyte antigen antibodies (DSAs) are reportedly associated with an increased risk of kidney graft failure, but there is little information on preformed complement-binding DSAs. This study investigated the correlation between preformed C1q-binding DSAs and medium-term outcomes in kidney transplantation (KT). Methods: We retrospectively studied 44 pretransplant DSA-positive patients, including 36 patients who underwent KT between April 2010 and October 2016. There were 17 patients with C1q-binding DSAs and 27 patients without C1q-binding DSAs. Clinical variables were examined in the 2 groups. Results: Patients with C1q-binding DSAs had significantly higher blood transfusion history (53.0% vs 18.6%; P =.0174), complement-dependent cytotoxicity crossmatch (CDC-XM)-positivity (29.4% vs 0%; P =.0012), and DSA median fluorescence intensity (MFI) (10,974 vs 2764; P =.0009). Among patients who were not excluded for CDC-XM-positivity and underwent KT, there was no significant difference in cumulative biopsy-proven acute rejection rate (32.5% vs 33.5%; P =.8354), cumulative graft survival, and 3-month and 12-month protocol biopsy results between patients with and without C1q-binding DSAs. Although patients with C1q-binding DSAs showed a higher incidence of delayed graft function (54.6% vs 20.0%; P =.0419), multivariate logistic regression showed that DSA MFI (P =.0124), but not C1q-binding DSAs (P =.2377), was an independent risk factor for delayed graft function. Conclusions: In patients with CDC-XM-negativity, preformed C1q-binding DSAs were not associated with incidence of antibody-mediated rejection and medium-term graft survival after KT. C1q-binding DSAs were highly correlated with DSA MFI and CDC-XM-positivity.

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