Medizinische Universität Graz - Research portal
Selected Publication:
SHR Neuro Cancer Cardio Lipid Metab Microb
Schaefer, SM; Süsal, C; Opelz, G; Döhler, B; Becker, LE; Klein, K; Sickmüller, S; Waldherr, R; Macher-Goeppinger, S; Schemmer, P; Beimler, J; Zeier, M; Morath, C.
Pre-transplant soluble CD30 in combination with total DSA but not pre-transplant C1q-DSA predicts antibody-mediated graft loss in presensitized high-risk kidney transplant recipients.
HLA. 2016; 87(2):89-99
Doi: 10.1111/tan.12735
Web of Science
PubMed
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FullText_MUG
- Co-authors Med Uni Graz
- Schemmer Peter
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- Abstract:
- Presensitized kidney transplant recipients are at high-risk for early antibody-mediated rejection. We studied the impact of pre- and post-transplant donor-specific human leukocyte antigen (HLA) antibodies (DSA) and T-cell-activation on the occurrence of antibody-mediated rejection episodes (AMR) and graft loss (AMR-GL) in a unique cohort of 80 desensitized high-risk kidney transplant recipients. Patients with pre-transplant DSA demonstrated more AMR episodes than patients without DSA, but did not show a significantly increased rate of AMR-GL. The rates of AMR and AMR-GL were not significantly increased in patients with complement split product (C1q)-binding pre-transplant DSA. Pre-transplant C1q-DSA became undetectable post-transplant in 11 of 13 (85%) patients; 2 (18%) of these 11 patients showed AMR but no AMR-GL. In contrast, the post-transplant presence of C1q-DSA was associated with significantly higher rates of AMR (86 vs 33 vs 0%; P < 0.001) and AMR-GL (86 vs 0 vs 0%; log-rank P < 0.001) compared with post-transplant DSA without C1q-binding or the absence of DSA. Patients with both pre-transplant DSA and evidence of pre-transplant T-cell-activation as indicated by soluble CD30-positivity showed a significantly increased risk for AMR-GL [HR = 11.1, 95% confidence interval (CI) = 1.68-73.4; log-rank P = 0.013]. In these high-risk patients, AMR-GL was associated with total DSA in combination with T-cell-activation pre-transplant, and de novo or persistent C1q-binding DSA post-transplant. © 2016 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.
- Find related publications in this database (using NLM MeSH Indexing)
- Adult -
- Aged -
- Antigens, CD30 - blood
- Antigens, CD30 - immunology
- Complement C1 - immunology
- Complement C1 - metabolism
- Female -
- Graft Rejection - blood
- Graft Rejection - immunology
- Humans -
- Isoantibodies - blood
- Isoantibodies - immunology
- Kidney Transplantation -
- Lymphocyte Activation -
- Male -
- Middle Aged -
- Predictive Value of Tests -
- Preoperative Period -
- T-Lymphocytes - immunology
- T-Lymphocytes - metabolism
- Find related publications in this database (Keywords)
- antibody-mediated rejection
- B-cell
- C1q
- donor-specific antibodies
- human leukocyte antigen
- increased soluble CD30
- kidney
- rejection
- transplantation