Complement-fixing donor-specific anti-HLA antibodies and kidney allograft failure

dc.contributor.authorCazarote H.B.
dc.contributor.authorShimakura S.
dc.contributor.authorValdameri J.S.
dc.contributor.authorContieri F.L.C.
dc.contributor.authorvon Glehn C.Q.C.
dc.contributor.authorAita C.M.
dc.contributor.authorSusin M.F.
dc.contributor.authorSotomaior V.S.
dc.contributor.authorGlehn-Ponsirenas R.
dc.date.accessioned2024-03-12T23:57:21Z
dc.date.available2024-03-12T23:57:21Z
dc.date.issued2018
dc.description.abstract© 2018 Elsevier B.V.Detection of donor-specific antibodies (DSA) has improved the risk classification and post-transplant evaluation of kidney recipients. Moreover, assessment of DSA C1q-binding ability has been shown to improve the individual risk classification of transplant patients for allograft loss, especially when detected after transplantation. The aim of this study was to evaluate the additional clinical impact of C1q-binding DSA detection in a population that was extensively monitored for DSA and MFI alterations. Forty-two kidney allograft recipients were followed-up at multiple time points for up to 5 years after transplantation for the presence of anti-HLA DSA-IgG total. The samples that were positive for these antibodies were retrospectively tested for the presence of complement-binding antibodies. Overall, 24 patients presented DSA, 29% (7) of which also produced complement-binding DSA. Compared to patients with non-C1q-binding DSA and non-sensitized patients, patients with C1q-binding DSA after transplantation had the lowest allograft survival rate at 5 years (p = 0.042) and showed a lower estimated glomerular filtration rate (based on the Modification of Diet in Renal Disease formula) during the post-transplant follow-up period (p = 0.01). Thus, post-transplant monitoring for complement-binding DSA is a useful tool for predicting individuals most at risk for allograft failure, and might also be beneficial for evaluation of immunosuppression regimens.
dc.description.firstpage33
dc.description.lastpage38
dc.description.volume49
dc.identifier.doi10.1016/j.trim.2018.03.002
dc.identifier.issn1878-5492
dc.identifier.urihttps://dspace.mackenzie.br/handle/10899/35501
dc.relation.ispartofTransplant Immunology
dc.rightsAcesso Restrito
dc.subject.otherlanguageAllograft dysfunction
dc.subject.otherlanguageAllograft loss
dc.subject.otherlanguageAntibody-mediated rejection (ABMR)
dc.subject.otherlanguageC1q-binding
dc.subject.otherlanguageDonor-specific antibodies (DSA)
dc.subject.otherlanguageKidney transplantation
dc.titleComplement-fixing donor-specific anti-HLA antibodies and kidney allograft failure
dc.typeArtigo
local.scopus.citations7
local.scopus.eid2-s2.0-85044505287
local.scopus.subjectAdult
local.scopus.subjectComplement Activation
local.scopus.subjectComplement C1q
local.scopus.subjectFemale
local.scopus.subjectFollow-Up Studies
local.scopus.subjectGlomerular Filtration Rate
local.scopus.subjectGraft Rejection
local.scopus.subjectGraft Survival
local.scopus.subjectHLA Antigens
local.scopus.subjectHumans
local.scopus.subjectIsoantibodies
local.scopus.subjectKidney Transplantation
local.scopus.subjectMale
local.scopus.subjectMiddle Aged
local.scopus.subjectPrognosis
local.scopus.subjectProtein Binding
local.scopus.subjectRetrospective Studies
local.scopus.subjectRisk
local.scopus.subjectTissue Donors
local.scopus.subjectTransplantation, Homologous
local.scopus.updated2024-05-01
local.scopus.urlhttps://www.scopus.com/inward/record.uri?partnerID=HzOxMe3b&scp=85044505287&origin=inward
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