Pre-transplant donor-specific HLA antibodies and risk for poor first-year renal transplant outcomes: results from the Swiss Transplant Cohort Study.
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State: Public
Version: Final published version
License: All rights reserved
Serval ID
serval:BIB_AD21EC0FD8B7
Type
Article: article from journal or magazin.
Collection
Publications
Institution
Title
Pre-transplant donor-specific HLA antibodies and risk for poor first-year renal transplant outcomes: results from the Swiss Transplant Cohort Study.
Journal
Transplant international
Working group(s)
Swiss Transplant Cohort Study
Contributor(s)
Axel A., Aubert J.D., Banz V., Sonja B., Beldi G., Berger C., Berishvili E., Binet I., Bochud P.Y., Branca S., Bucher H., Carrel T., Catana E., Chalandon Y., De Geest S., De Rougemont O., Dickenmann M., Dreifuss J.L., Duchosal M., Fehr T., Franscini N., Garzoni C., Soccal P.G., Gaudet C., Goossens N., Halter J., Heim D., Hess C., Hillinger S., Hirsch H., Hirt P., Hofbauer G., Huynh-Do U., Immer F., Koller M., Laager M., Laesser B., Lehmann R., Leichtle A., Lovis C., Manuel O., Marti H.P., Martin P.Y., Martinelli M., McLin V., Mellac K., Merçay A., Mettler K., Mueller N., Müller A., Müller T., Müller-Arndt U., Müllhaupt B., Nägeli M., Oldani G., Pascual M., Posfay-Barbe K., Rick J., Rosselet A., Rossi S., Rothlin S., Ruschitzka F., Schanz U., Schuurmans M., Sengstag T., Simonetta F., Staufer K., Stampf S., Steiger J., Stirniman G., Stürzinger U., Van Delden C., Venetz J.P., Villard J., Vionnet J., Wick M., Wilhlem M., Yerly P.
ISSN
1432-2277 (Electronic)
ISSN-L
0934-0874
Publication state
Published
Issued date
12/2021
Peer-reviewed
Oui
Volume
34
Number
12
Pages
2755-2768
Language
english
Notes
Publication types: Journal Article
Publication Status: ppublish
Publication Status: ppublish
Abstract
The aim of this study was to analyze first year renal outcomes in a nationwide prospective multicenter cohort comprising 2215 renal transplants, with a special emphasis on the presence of pre-transplant donor-specific HLA antibodies (DSA). All transplants had a complete virtual crossmatch and DSA were detected in 19% (411/2215). The investigated composite endpoint was a poor first-year outcome defined as (i) allograft failure or (ii) death or (iii) poor allograft function (eGFR ≤25 ml/min/1.73 m <sup>2</sup> ) at one year. Two hundred and twenty-one (221/2215; 10%) transplants showed a poor first-year outcome. Rejection (24/70; 34%) was the most common reason for graft failure. First-year patient's death was rare (48/2215; 2%). There were no statistically significant differences between DSA-positive and DSA-negative transplants regarding composite and each individual endpoint, as well as reasons for graft failure and death. DSA-positive transplants experienced more frequently rejection episodes, mainly antibody-mediated rejection (both P < 0.0001). The combination of DSA and any first year rejection was associated with the overall poorest death-censored allograft survival (P < 0.0001). In conclusion, presence of pre-transplant DSA per se does not affect first year outcomes. However, DSA-positive transplants experiencing first year rejection are a high-risk population for poor allograft survival and may benefit from intense clinical surveillance.
Keywords
DSA, Donor-specific HLA antibodies, allograft failure, death with functioning graft, graft loss, rejection, renal transplantation, allograft loss, donor-specific HLA antibodies
Pubmed
Web of science
Create date
04/10/2021 11:39
Last modification date
10/08/2024 7:30