Donor-Specific Antibodies Adversely Affect Kidney Allograft Outcomes
Donor-Specific Antibodies Adversely Affect Kidney Allograft Outcomes
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DOI：
10.1681/asn.2012070664
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发表时间：
2012-12-01
影响因子：
13.6
通讯作者：
Radhakrishnan, Jai
中科院分区：
文献类型：
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作者：
Mohan, Sumit;Palanisamy, Amudha;Radhakrishnan, Jai
仅通过敏感的固相检测(SPA)检测的低滴度供者特异性抗体(DSA)对肾移植结果的影响尚不清楚。我们报告了对肾移植受者的排斥率和移植结果的系统回顾和荟萃分析的结果，根据SPA阳性结果而补体依赖细胞毒性阴性和流式细胞术交叉匹配结果来定义这些预先形成的DSA。我们的搜索确定了7项回顾性队列研究，总共包括1119名患者，包括145名孤立的DSA-SPA患者。总之，这些研究表明，尽管流式细胞术交叉配型结果为阴性，但DSA-SPA的存在几乎使抗体介导的排斥反应的风险增加了一倍(相对风险[RR]，1.98；95%可信区间[CI]，1.36-2.89；P
The effect of low titers of donor-specific antibodies (DSAs) detected only by sensitive solid-phase assays (SPAs) on renal transplant outcomes is unclear. We report the results of a systematic review and meta-analysis of rejection rates and graft outcomes for renal transplant recipients with such preformed DSAs, defined by positive results on SPA but negative complement-dependent cytotoxicity and flow cytometry crossmatch results. Our search identified seven retrospective cohort studies comprising a total of 1119 patients, including 145 with isolated DSA-SPA. Together, these studies suggest that the presence of DSA-SPA, despite a negative flow cytometry crossmatch result, nearly doubles the risk for antibody-mediated rejection (relative risk [RR], 1.98; 95% confidence interval [Cl], 1.36-2.89; P