scholarly journals Intensity of de novo DSA detected by Immucor Lifecodes assay and C3d fixing antibodies are not predictive of subclinical ABMR after Kidney Transplantation

PLoS ONE ◽  
2021 ◽  
Vol 16 (4) ◽  
pp. e0249934
Author(s):  
Dominique Bertrand ◽  
Rangolie Kaveri ◽  
Charlotte Laurent ◽  
Philippe Gatault ◽  
Maïté Jauréguy ◽  
...  
Keyword(s):  
Kidney Transplantation ◽  
Prognostic Value ◽  
De Novo ◽  
Added Value ◽  
Multicentric Study ◽  
Specific Antibodies ◽  
Antibody Mediated Rejection ◽  
Single Antigen ◽  
Donor Specific Antibodies ◽  
Allograft Loss

De novo donor-specific antibodies (dnDSA) are associated with antibody-mediated rejection (ABMR) and allograft loss. We tested Immucor* (IM) Luminex Single-antigen beads (LSAB) assay and C3d-fixing antibodies in the setting of dnDSA and subclinical (s) ABMR. This retrospective multicentric study included 123 patients biopsied because of the presence of subclinical de novo DSA detected by One Lamda* Labscreen (MFI > 1000). In 112 patients, sera of the day of the biopsy were available and tested in a central lab with IM Lifecodes LSAB and C3d fixing antibodies assays. In 16 patients (14.3%), no DSA was detected using Immucor test. In 96 patients, at least one DSA was determined with IM. Systematic biopsies showed active sABMR in 30 patients (31.2%), chronic active sABMR in 17 patients (17.7%) and no lesions of sABMR in 49 KT recipients (51%). Intensitity criteria (BCM, BCR and AD-BCR) of DSA were not statistically different between these 3 histological groups. The proportion of patients with C3d-fixing DSA was not statistically different between the 3 groups and did not offer any prognostic value regarding graft survival. Performing biopsy for dnDSA could not be guided by the intensity criteria of IM LSAB assay. C3d-fixing DSA do not offer added value.

scholarly journals Clinical relevance of HLA donor-specific antibodies detected by single antigen assay in kidney transplantation

2011 ◽  
Vol 27 (3) ◽  
pp. 1231-1238 ◽  
Author(s):  
J. L. Caro-Oleas ◽  
M. F. Gonzalez-Escribano ◽  
F. M. Gonzalez-Roncero ◽  
M. J. Acevedo-Calado ◽  
V. Cabello-Chaves ◽  
...  
Keyword(s):  
Kidney Transplantation ◽  
Clinical Relevance ◽  
Specific Antibodies ◽  
Antigen Assay ◽  
Single Antigen ◽  
Donor Specific Antibodies

Antibody-Mediated Rejection With and Without HLA Donor-Specific Antibodies in Kidney-Transplantation

2018 ◽  
Vol 102 ◽  
pp. S211-S212 ◽  
Author(s):  
Marta Crespo ◽  
Dolores Redondo ◽  
Carrie Butler ◽  
Javier Gimeno ◽  
Carme Garcia ◽  
...  
Keyword(s):  
Kidney Transplantation ◽  
Specific Antibodies ◽  
Antibody Mediated Rejection ◽  
Donor Specific Antibodies

scholarly journals Donor-Specific Antibodies in Kidney Transplant Recipients

2017 ◽  
Vol 13 (1) ◽  
pp. 182-192 ◽  
Author(s):  
Rubin Zhang
Keyword(s):  
Kidney Transplant ◽  
De Novo ◽  
Binding Capacity ◽  
Graft Loss ◽  
Igg Subclasses ◽  
Kidney Transplant Recipients ◽  
Specific Antibodies ◽  
Antibody Mediated Rejection ◽  
Donor Specific Antibodies ◽  
Transplant Glomerulopathy

Donor-specific antibodies have become an established biomarker predicting antibody-mediated rejection. Antibody-mediated rejection is the leading cause of graft loss after kidney transplant. There are several phenotypes of antibody-mediated rejection along post-transplant course that are determined by the timing and extent of humoral response and the various characteristics of donor-specific antibodies, such as antigen classes, specificity, antibody strength, IgG subclasses, and complement binding capacity. Preformed donor-specific antibodies in sensitized patients can trigger hyperacute rejection, accelerated acute rejection, and early acute antibody-mediated rejection. De novo donor-specific antibodies are associated with late acute antibody-mediated rejection, chronic antibody-mediated rejection, and transplant glomerulopathy. The pathogeneses of antibody-mediated rejection include not only complement-dependent cytotoxicity, but also complement-independent pathways of antibody-mediated cellular cytotoxicity and direct endothelial activation and proliferation. The novel assay for complement binding capacity has improved our ability to predict antibody-mediated rejection phenotypes. C1q binding donor-specific antibodies are closely associated with acute antibody-mediated rejection, more severe graft injuries, and early graft failure, whereas C1q nonbinding donor-specific antibodies correlate with subclinical or chronic antibody-mediated rejection and late graft loss. IgG subclasses have various abilities to activate complement and recruit effector cells through the Fc receptor. Complement binding IgG3 donor-specific antibodies are frequently associated with acute antibody-mediated rejection and severe graft injury, whereas noncomplement binding IgG4 donor-specific antibodies are more correlated with subclinical or chronic antibody-mediated rejection and transplant glomerulopathy. Our in-depth knowledge of complex characteristics of donor-specific antibodies can stratify the patient’s immunologic risk, can predict distinct phenotypes of antibody-mediated rejection, and hopefully, will guide our clinical practice to improve the transplant outcomes.

scholarly journals Biopsy findings after detection of de novo donor-specific antibodies in renal transplant recipients: a single center experience

2021 ◽  
Author(s):  
Christoph B. Waldecker ◽  
Panagiota Zgoura ◽  
Felix S. Seibert ◽  
Sabina Gall ◽  
Peter Schenker ◽  
...  
Keyword(s):  
De Novo ◽  
Substantial Reduction ◽  
Renal Transplant Recipients ◽  
Transplant Recipients ◽  
Single Center ◽  
Specific Antibodies ◽  
Antibody Mediated Rejection ◽  
Allograft Biopsy ◽  
Increased Risk ◽  
Donor Specific Antibodies

Abstract Background De novo donor-specific antibodies (DSA) are associated with an increased risk of antibody-mediated rejection and a substantial reduction of allograft survival. We hypothesized that detection of DSA should prompt a biopsy even in the absence of proteinuria and loss of estimated glomerular filtration rate (eGFR). However, data on a population without proteinuria or loss of kidney function is scant, and this is the main novelty of our study design. Methods Single center retrospective analysis on biopsy findings after detection of de novo DSA. One-hundred-thirty-two kidney and pancreas-kidney transplant recipients were included. Eighty-four of these patients (63.6%) underwent allograft biopsy. At the time of biopsy n = 50 (59.5%) had a protein/creatinine ratio (PCR) > 300 mg/g creatinine and/or a loss of eGFR ≥ 10 ml/min in the previous 12 months, whereas 40.5% did not. Diagnosis of rejection was performed according to Banff criteria. Results Seventy-seven (91.7%) of the biopsies had signs of rejection (47.6% antibody mediated rejection (ABMR), 13.1% cellular, 20.2% combined, 10.7% borderline). Among subjects without proteinuria or loss of eGFR ≥ 10 ml/min/a (n = 34), 29 patients (85.3%) showed signs of rejection (44.1% antibody mediated (ABMR), 14.7% cellular, 11.8% combined, 14.7% borderline). Conclusion The majority of subjects with de novo DSA have histological signs of rejection, even in the absence of proteinuria and deterioration of graft function. Thus, it appears reasonable to routinely perform an allograft biopsy after the detection of de novo DSA. Graphic abstract

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