Subscribe to RSS
![](/products/assets/desktop/img/oa-logo.png)
DOI: 10.4103/1947-489X.211051
Even a single, remotely positive post-transplant alloantibody test correlates with increased chronic allograft nephropathy and graft loss after kidney transplantation
![](https://www.thieme-connect.de/media/10.1055-s-00053247/200901/lookinside/thumbnails/10-4103-1947-489x-211051_211051-1.jpg)
Abstract
Background: Chronic renal allograft loss is considered as immunologically mediated when donor-specific alloantibodies are detected. However, remotely detected alloantibodies with lack of detection more proximate to graft loss occurrence may obscure the humoral association with graft damage.
Methods: We retrospectively reviewed 609 patients multiply tested post-transplant for detectable alloantibodies and correlated their results with clinical outcomes.
Results: Most patients had no detectable post-transplant alloantibodies (Group 1, n = 393), some converted from nondetectable to detectable alloantibodies (Group 2, n = 97), some always had detectable post-transplant alloantibodies (Group 3, n = 69), and some demonstrated alloantibodies that subsequently became undetectable (Group 4, n = 50). The incidence of death-censored graft survival for Group 4 patients was similar to Group 2 and 3 patients, and greater than Group 1 patients. Further, interstitial fibrosis/tubularatrophy (IF/TA) free survival was significantly worse (p=0.018) for Group 4 versus Group 1 recipients. Also, Group 4 versus Group 1 IF/TA-free survival was worse when recipients were regrouped based solely on anti-HLA class II (p=0.006), but not anti-HLA class I (p=ns) antibodies.
Conclusions: Detectable anti-HLA antibodies, even remotely, post-transplant identifies recipients at greater risk for IF/TA associated graft loss when compared to patients without detectable alloantibodies.
Publication History
Received: 15 May 2009
Accepted: 10 July 2009
Article published online:
23 May 2022
© 2009. The Author(s). This is an open access article published by Thieme under the terms of the Creative Commons Attribution-NonDerivative-NonCommercial License, permitting copying and reproduction so long as the original work is given appropriate credit. Contents may not be used for commercial purposes, or adapted, remixed, transformed or built upon. (https://creativecommons.org/licenses/by-nc-nd/4.0/)
Thieme Medical and Scientific Publishers Pvt. Ltd.
A-12, 2nd Floor, Sector 2, Noida-201301 UP, India