PubMed · 2007 · 13 citations · 0 references
Life SciencesImmunologyNephrologyImmunogeneticsKidney TransplantationTransplant ImmunologyAllograft RejectionChronic RejectionDonor-specific AntibodiesGraft RejectionGraft SurvivalHistocompatibilityClass I Hla AntibodiesDonor-specific Hla AntibodiesGraft Failure DetectionLong-term Graft FunctionLong-term Graft SurvivalNon-hla AntibodiesPost-transplant Rejection Risk PredictionPreexisting Donor-specific Antibodies
The three-year follow-up of 4,144 patients of the 14th International Workshop Prospective Chronic Rejection study has reinforced the evidence that post-transplant HLA antibodies are predictive of long-term graft loss. Three years after a single testing for HLA antibodies, 10% of kidney recipients who were antibody-positive had lost their grafts, in contrast to only 5% of antibody-negative patients (p<0.0001). The adverse effect of post-transplant antibodies on graft survival was also observed in lung, heart, and liver transplants. Donor-specific antibodies and 'strong' non-DSA had stronger association with graft loss than 'moderate' non-DSA. Periodic antibody monitoring, combined with specificity and strength analysis, would help in the early identification of allograft recipients who are at high risk of graft failure.