Background: Antibody-mediated rejection (AMR) is responsible for a large proportion of early allograft losses. While preformed donor-specific human leukocyte antigen (HLA)-antibodies (HLA-DSA) are accountable for the majority of these episodes, non-HLA-DSA are also involved. However, data on the incidence of early AMR due to non-HLA-DSA are currently lacking.
Methods: This study evaluated (i) the incidence of early AMR due to non-HLA-DSA -- defined by exclusion of circulating HLA-DSA detected by flow beads -- and (ii) the association with donor-specific major histocompatibility complex class I chain-related gene (MICA)-antibodies (MICA-DSA) and angiotensin-receptor antibodies. A retrospective cohort (n=279) risk stratified by complement-dependent cytotoxicity crossmatches (CDC-XM era) and a prospective cohort (n=154) risk stratified by virtual crossmatching using flow beads (virtual-XM era) were investigated.
Results: In the CDC-XM era 25/279 patients (9%) developed early AMR, but only 3/154 patients (2%) in the virtual-XM era (P=0.004). The incidence of early AMR due to HLA-DSA was significantly higher in the CDC-XM era than in virtual-XM era (18/279 patients [6.5%] vs. 0/154 patients [0%]; P=0.0005). However, the incidence of early AMR presumably due to non-HLA-DSA remained unchanged in these two cohorts (7/279 patients [2.5%] vs. 3/154 patients [2%]; P=1.0) consistent with a persisting gap in the ability to identify preformed DSA. Overall, 10/433 patients (2.3%) experienced early AMR presumably due to non-HLA-DSA. None of these 10 patients had angiotensin-receptor antibodies, at most 3/10 patients had MICA-DSA, while the antibodies remained unexplained in 7/10 cases.
Conclusion: Early AMR due to non-HLA-DSA is a rare event, which is still difficult to predict by currently available assays.
Download full-text PDF |
Source |
|---|---|
| http://dx.doi.org/10.1097/TP.0b013e31816f612a | DOI Listing |
Publication Analysis
Top Keywords
Similar Publications
Follow-up biopsies with microvascular inflammation and persistent donor specific antibodies identify ongoing rejection in pediatric kidney transplant recipients.
Pediatr Nephrol
January 2025
Department of Pediatrics, University of California San Diego, 3020 Children's Way MC 5137, San Diego, CA, 92123, USA.
Background: Inadequate treatment of acute rejection (AR) in pediatric kidney transplant recipients (KTR) can contribute to early allograft failure. Serum creatinine is an insensitive marker of allograft function, especially in the pediatric population, and may not detect ongoing rejection after treatment. We evaluated the utility of follow-up biopsies to detect persistent inflammation and future episodes of rejection.
View Article and Find Full Text PDFUnveiling results and insights from multinational, multicenter Study of Prescribing patterns and Effectiveness of Ceftolozane/Tazobactam Real-world Analysis (SPECTRA).
J Glob Antimicrob Resist
January 2025
Dept of Respiratory Medicine, Harefield Hospital, Hill End Rd, UB9 6JH, London, UK. Electronic address:
Objectives: Antibacterial-resistant gram-negative hospital-acquired infections result in significant morbidity and mortality. In clinical trials, ceftolozane/tazobactam (C/T) has been effective against these infections; however, real-world findings are limited.
Methods: SPECTRA was a global, retrospective, observational inpatient study of adults treated with C/T for ≥48 hours, conducted between 2016 and 2020.
Antimicrobial Resistance Genes in Clinical Strains from Livestock and Poultry in Shandong Province, China During 2015-2020.
Antibiotics (Basel)
January 2025
Shandong Center for Animal Disease Control and Prevention, Shandong Centre for Zoonotic Disease Surveillance, Jinan 250100, China.
Antimicrobial resistant (AMR) () isolated from animals may lead to antibiotic treatment failure and economic losses to farmers. The co-existence of antimicrobial resistant genes (ARGs) in the same isolate presents a major challenge for the prevention and control of infection in multidrug-resistant (MDR) Gram-negative organisms. There have been a lot of studies on the antibiotic resistance of in livestock and poultry, but few of them have focused on clinical pathogens.
View Article and Find Full Text PDFRacial Variation of Donor-Derived Cell-Free DNA in Kidney Transplant Recipients.
Prog Transplant
January 2025
Department of Surgery, Rush University Medical Center, University Transplant Program, Chicago, IL, USA.
Introduction: There is a need for a noninvasive, affordable, sensitive, and specific biomarker to diagnose early acute rejection, to negate the need for frequent biopsies. Dd-cfDNA is a powerful adjunct yet there is limited data on the ethnic differences in its values. There is anecdotal evidence that dd-cfDNA values at rejection may be higher in Black as compared to non-Black recipients.
View Article and Find Full Text PDFCirculating tumour DNA in early stage and locally advanced NSCLC: ready for clinical implementation?
Nat Rev Clin Oncol
January 2025
Cell Biology and Biotherapy Unit, Istituto Nazionale Tumori - IRCCS - Fondazione G. Pascale, Napoli, Italy.
Circulating tumour DNA (ctDNA) can be released by cancer cells into biological fluids through apoptosis, necrosis or active release. In patients with non-small-cell lung cancer (NSCLC), ctDNA levels correlate with clinical and pathological factors, including histology, tumour size and proliferative status. Currently, ctDNA analysis is recommended for molecular profiling in patients with advanced-stage NSCLC.
View Article and Find Full Text PDFWant AI Summaries of new PubMed Abstracts delivered to your In-box?
Enter search terms and have AI summaries delivered each week - change queries or unsubscribe any time!