Risk of Antibody-Mediated Rejection in Kidney Transplant Recipients With Anti-HLA-C Donor-Specific Antibodies
Risk of Antibody-Mediated Rejection in Kidney Transplant Recipients With Anti-HLA-C Donor-Specific Antibodies
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DOI：
10.1111/ajt.12709
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发表时间：
2014-06-01
影响因子：
8.8
通讯作者：
Sberro-Soussan, R.
中科院分区：
文献类型：
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作者：
Aubert, O.;Bories, M. -C.;Sberro-Soussan, R.
抗HLA供者特异性抗体（DSA）可引起急性和慢性抗体介导的排斥反应（AMR）。然而，抗HLA-C抗体的临床相关性仍不清楚。我们评估了肾移植受者在第0天DSA中存在抗HLA-C抗体的临床相关性。在这项回顾性病例对照研究中，对2008年8月至2012年3月期间接受肾移植的608例患者进行了筛查，以确定第0天是否存在分离的抗HLA-C DSA。共选择了22例肾移植受者，并随访1年。AMR根据Banff分类法进行分类。将22例患者与88例免疫患者进行比较。6例患者（27.3%）被诊断为急性AMR。第0天DSA的中位数为1179（530- 17941）。AMR组抗C组的平均荧光强度为4966（978-17 941），无AMR患者组为981（530-8012）。88名免疫个体（9.1%）中急性AMR的诊断频率低于DSA抗C组（p = 0.033）。第0天的DSA水平可预测AMR（p = 0.017）。移植前抗HLA-C DSA水平高的患者可能在移植后第一年发生急性AMR。
Anti-HLA donor-specific antibodies (DSAs) cause acute and chronic antibody-mediated rejection (AMR). However, the clinical relevance of anti-HLA-C antibodies remains unclear. We evaluated the clinical relevance of the presence of anti-HLA-C DSA at day 0 in renal transplant recipients. In this retrospective, case-controlled study, 608 patients who underwent kidney transplantation between August 2008 and March 2012 were screened for the presence of isolated anti-HLA-C DSA at day 0. A total of 22 renal transplant recipients were selected and followed for a period of 1 year. AMR was classified according to the Banff classification. The 22 patients were compared with 88 immunized patients. Acute AMR was diagnosed in six patients (27.3%). The median level of DSA at day 0 was 1179 (530-17 941). The mean fluorescence intensity in the anti-C group was 4966 (978-17 941) in the AMR group and 981 (530-8012) in the group of patients without AMR. Acute AMR was diagnosed less frequently in the 88 immunized individuals (9.1%) than in the DSA anti-C group (p = 0.033). The level of DSA at day 0 was predictive for AMR (p = 0.017). Patients with a high level of pretransplant anti-HLA-C DSAs are likely to develop acute AMR during the first year after transplantation.