Early clearance vs persistence of de novo donor-specific antibodies following lung transplantation.

Background: The natural history of de novo donor-specific antibodies (dnDSA) after lung transplantation is not well-described. We sought to determine the incidence and risk factors associated with dnDSA and compare outcomes between recipients with transient (or isolated) vs persistent dnDSA after transplantation.

Methods: A single-center review of all lung transplants from 1/2009-7/2013.

Barriers to preemptive renal transplantation: a single center questionnaire study.

Background: Preemptive transplantation results in excellent patient and graft survival yet most transplant candidates are referred for transplantation after initiation of dialysis. The goal of this study was to determine barriers to preemptive renal transplantation.

Methods: A nonvalidated questionnaire was administered to prospective kidney transplant recipients to determine factors that hindered or favored referral for transplantation before the initiation of dialysis.

Intermediate-term graft loss after renal transplantation is associated with both donor-specific antibody and acute rejection.

Background: Renal transplant recipients with de novo DSA (dDSA) experience higher rates of rejection and worse graft survival than dDSA-free recipients. This study presents a single-center review of dDSA monitoring in a large, multi-ethnic cohort of renal transplant recipients.

Methods: The authors performed a nested case-control study of adult kidney and kidney-pancreas recipients from July 2007 through July 2011.

Screening for BK viremia reduces but does not eliminate the risk of BK nephropathy: a single-center retrospective analysis.

Background: This study reviewed the outcomes of a screening protocol for BK viremia to determine if early diagnosis, followed by immunosuppression minimization, would prevent progression to nephropathy and graft loss.

Methods: This review included 369 renal transplant recipients tested for BK virus at serial time points after transplantation. Management included immunosuppression minimization plus cidofovir treatment for BK nephropathy.

Donor-specific HLA-DQ antibodies may contribute to poor graft outcome after renal transplantation.

Increasing evidence suggests a detrimental effect of donor-specific antibodies directed against the human leukocyte antigen (HLA)-A, -B, and -DR loci on renal allograft outcomes. Limited data exist on the impact of de novo HLA-DQ antibodies. Over a 3-year period, we prospectively monitored 347 renal transplant recipients without pre-transplant donor-specific antibodies for their development de novo.