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The Presence of Pretransplant Antiphospholipid Antibodies IgA Anti-β-2-Glycoprotein I as a Predictor of Graft Thrombosis After Renal Transplantation. | LitMetric

AI Article Synopsis

  • Vessel thrombosis is a serious risk after kidney transplants, particularly linked to IgA-aB2GP1 antibodies found in some patients.
  • In a study of 1,375 kidney transplant patients, those with these antibodies (29.2%) experienced significantly higher rates of graft loss and early complications due to thrombosis compared to those without them.
  • The presence of IgA-aB2GP1 was identified as a key independent risk factor for these issues, suggesting that further research on anticoagulation treatments for affected patients is necessary.

Article Abstract

Background: Vessel thrombosis is a severe complication after renal transplantation. Antibodies anti-β-2 glycoprotein-I of IgA isotype (IgA-aB2GP1) have been linked to thrombotic events and mortality in hemodialysis patients.

Methods: All kidney transplanted patients from 2000 to 2011 (n = 1375) in our hospital were followed up for 2 years, evaluating 3 time periods.

Results: At transplantation, 401 patients were positive for IgA-aB2GPI (29.2%, group 1), and the remaining patients were negative (group 2). Graft loss at 6 months posttransplantation was higher in group 1 (18% vs 7.2%; P < 0.001). The most frequent cause of early graft loss was vessel thrombosis, especially in group 1 (12.2% vs 2.6% of patients; P < 0.001). In fact, vessel thrombosis was the most important cause of graft loss in the 3 time periods, irrespective of demographic changes and introduction of transplantation with asystolic donors.Notably, IgA-aB2GP1 was an independent risk factor for graft thrombosis (odds ratio, 5.047; P < 0.001). Furthermore, the presence of IgA-aB2GP1 was associated with early graft loss and delayed graft function. Mortality at 24 months was also higher in group 1.

Conclusions: In conclusion, pretransplant IgA-aB2GP1 was the main risk factor for graft thrombosis and early graft loss. Further research should be made on whether anticoagulation in antibody-positive patients could ameliorate this catastrophic complication.

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Source
http://dx.doi.org/10.1097/TP.0000000000001199DOI Listing

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