AI Article Synopsis
- The study focused on the presence and impact of preformed denatured HLA donor-specific antibodies (DSA) in kidney transplant recipients who are sensitized to class I HLA.
- Out of 179 patients, 85 class I DSAs were identified, but most were low intensity and the two testing methods used (anti-dHLA and SAFB+/iBeads-) showed strong agreement (90%).
- Importantly, patients with only these class I DSAs didn’t experience acute rejection or worse graft survival rates compared to those without DSAs, suggesting these antibodies may not significantly affect transplant outcomes.
Article Abstract
Class I single-antigen flow beads (SAFB) carry native and denatured human leukocyte antigen (HLA) molecules. Using a cohort of 179 class I HLA-sensitized kidney recipients, we described incidence and clinical relevance of preformed denatured HLA donor-specific antibodies (DSA) using two different assays: an acid-treated SAFB assay (anti-dHLA DSA) and the iBeads assays (SAFB+/iBeads- DSA). Eighty-five class I DSA were found in 67 patients (median mean fluorescence intensity [MFI] of 1729 [range 520-13 882]). Anti-dHLA and SAFB+/iBeads- DSA represented 11% and 18% of class I DSA and were mainly low MFI DSA (500-1000 MFI). Concordance between these two assays was good (90%). None of the patients with only class I anti-dHLA DSA or only SAFB+/iBeads- DSA developed acute clinical antibody-mediated rejection in the first-year post-transplantation, and their five-yr death-censored graft survival was similar to that of patients without DSA. Moreover, all these patients displayed a negative current T-cell flow cytometry cross-match. Therefore, both anti-dHLA DSA and SAFB+/iBeads- DSA appear irrelevant, which could explain the good outcome observed in some patients with preformed class I DSA.
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| http://dx.doi.org/10.1111/ctr.12529 | DOI Listing |
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Clinical impact of preformed donor-specific denatured class I HLA antibodies after kidney transplantation.
Clin Transplant
May 2015
Laboratoire d'Immunologie et Immunogénétique, Hôpital Pellegrin, CHU de Bordeaux, Bordeaux, France; UMR CNRS 5164, Université de Bordeaux, Bordeaux, France.
Article Synopsis
- The study focused on the presence and impact of preformed denatured HLA donor-specific antibodies (DSA) in kidney transplant recipients who are sensitized to class I HLA.
- Out of 179 patients, 85 class I DSAs were identified, but most were low intensity and the two testing methods used (anti-dHLA and SAFB+/iBeads-) showed strong agreement (90%).
- Importantly, patients with only these class I DSAs didn’t experience acute rejection or worse graft survival rates compared to those without DSAs, suggesting these antibodies may not significantly affect transplant outcomes.
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