Journal of the American Society of Nephrology· 2012Q1
Donor-Specific Antibodies Adversely Affect Kidney Allograft Outcomes
- 275citations
- Q1SCImago
- 2012year
Short summary
Kidney transplant recipients with donor-specific antibodies (DSAs) detected only by sensitive solid-phase assays (SPAs), despite negative crossmatch results, face nearly double the risk of antibody-mediated rejection and a 76% higher risk of graft failure.
AI-generated from the title and abstract; the full text is not read.
Key points
- Isolated donor-specific antibodies (DSA-SPA) detected by sensitive solid-phase assays (SPAs) are associated with worse kidney transplant outcomes.
- Patients with DSA-SPA and negative crossmatch results had a 1.98-fold increased risk of antibody-mediated rejection (P<0.001).
- Graft failure risk increased by 76% in patients with DSA-SPA compared to those without (P=0.01).
- The findings are based on a systematic review and meta-analysis of seven retrospective cohort studies involving 1119 patients.
AI-generated from the title and abstract; the full text is not read.
Abstract
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 [CI], 1.36-2.89; P<0.001) and increases the risk for graft failure by 76% (RR, 1.76; 95% CI, 1.13-2.74; P=0.01). These results suggest that donor selection should consider the presence of antibodies in the recipient, identified by the SPA, even in the presence of a negative flow cytometry crossmatch result.
The authors' abstract, as published at the source. Journal of the American Society of Nephrology, 2012 · DOI ↗
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Field: Transplantation
TransplantationMedicine