J Korean Med Sci.
2018 Aug;33(34):e217. 10.3346/jkms.2018.33.e217.
Characteristics and Clinical Significance of de novo Donor-Specific Anti-HLA Antibodies after Kidney Transplantation
- Affiliations
-
- 1Department of Internal Medicine, School of Medicine, Kyungpook National University, Kyungpook National University Hospital, Daegu, Republic of Korea. drcdkim@knu.ac.kr
- 2Department of Surgery, School of Medicine, Kyungpook National University, Kyungpook National University Hospital, Daegu, Republic of Korea.
- 3Department of Clinical Pathology, School of Medicine, Kyungpook National University, Kyungpook National University Hospital, Daegu, Republic of Korea.
- KMID: 2418615
- DOI: http://doi.org/10.3346/jkms.2018.33.e217
Abstract
- BACKGROUND
The association of de novo donor-specific anti-human leukocyte antigens (HLA) antibodies (DSA) and development of antibody-mediated rejection (AMR) in kidney transplant recipients (KTRs) is still undetermined.
METHODS
We prospectively screened de novo DSA in 167 KTRs during 32 months after kidney transplantation (KT). Timing of DSA detection was at 3, 6, and 12 months post-transplant and annually thereafter and when clinically indicated. DSA levels were determined by Luminex assays and expressed as mean fluorescence intensity (MFI). We evaluated the incidence, characteristics of DSA, and association between DSA and tacrolimus trough levels or AMR.
RESULTS
De novo DSA developed in 16 KTRs (9.6%) and acute AMR occurred more commonly in KTRs with de novo DSA compared to KTRs without de novo DSA (18.8% vs. 0%, P < 0.001). All de novo DSA were against class II antigens. The mean number of DSA was 1.8 ± 1.2 and the average MFI of DSA was 7,399 ± 5,470. Tacrolimus trough level during the first 0-2 months after KT was an independent predictor of DSA development (hazard ratio, 0.70; 95% confidence interval, 0.50-0.99; P = 0.043). No differences were found in the number of DSA, average MFI of DSA, and tacrolimus levels during the first year between de novo DSA-positive KTRs with AMR and those without AMR.
CONCLUSION
The results of our study suggest that monitoring of DSA and maintaining proper tacrolimus levels are essential to prevent AMR during the initial period after KT.
Keyword
- Full Text Links
-
- Actions
-
Cited
- CITED
-
- Close
- Share
-
- Similar articles
-
- Importance and What to Watch Out for de novo Donor Specific Anti-HLA Antibodies after Kidney Transplantation
- Evaluating the effect of Anti-HLA-DR51/52/53 donor-specific antibodies on antibody-mediated rejection in kidney transplantation recipients
- Continuous Monitoring of Donor Specific Anti-HLA Antibody in Kidney Transplantation Patients
- Association of human leukocyte antigen homozygosity and de novo malignancies in kidney transplant recipients
- Effect of preexisting human leukocyte antigen donor-specific antibodies especially human leukocyte antigen-DQ on kidney transplant outcome
