Impact of ABO Incompatibility on the Development of Acute Antibody-Mediated Rejection in Kidney Transplant Recipients Presensitized to HLA

Whether the coexistence of anti-A/B antibody and donor specific anti-HLA antibody (HLA-DSA) has a synergistic impact on the development of acute antibody-mediated rejection (AAMR) in kidney transplant recipients (KTRs) is unclear. This study includes 92 KTRs who received a kidney from an ABO-incompa...

Full description

Saved in:
Bibliographic Details
Published in:PloS one 2015-04, Vol.10 (4), p.e0123638-e0123638
Main Authors: Chung, Byung Ha, Joo, Yu Young, Lee, Jaesin, Kim, Hyung Duk, Kim, Ji-Il, Moon, In Sung, Choi, Bum Soon, Oh, Eun-Jee, Park, Cheol Whee, Kim, Yong-Soo, Yang, Chul Woo
Format: Article
Language:English
Subjects:
ABO Blood-Group System - immunology
ABO system
Adult
Antibodies
Antibodies - physiology
Antigens
Blood groups
Coexistence
Comparative analysis
Female
Graft rejection
Graft Rejection - blood
Graft Rejection - immunology
Graft Rejection - mortality
Histocompatibility antigen HLA
Histocompatibility testing
HLA Antigens - immunology
Humans
Immunoglobulins
Incompatibility
Internal medicine
Kaplan-Meier Estimate
Kidney Transplantation
Kidney transplants
Kidneys
Male
Medicine
Middle Aged
Nephrology
Rejection
Risk analysis
Risk Factors
Transplants & implants
Citations: Items that this one cites
Items that cite this one
Online Access:Get full text
Tags: Add Tag
No Tags, Be the first to tag this record!
Description
Summary:Whether the coexistence of anti-A/B antibody and donor specific anti-HLA antibody (HLA-DSA) has a synergistic impact on the development of acute antibody-mediated rejection (AAMR) in kidney transplant recipients (KTRs) is unclear. This study includes 92 KTRs who received a kidney from an ABO-incompatible (ABOi) donor or were presensitized to donor HLA (HLAs) and 292 controls (CONT). HLAs was defined as a crossmatch positivity or the presence of HLA-DSA. We compared the incidence of AAMR among ABOi (n = 58), ABOi+HLAs (n = 12), HLAs (n = 22), and CONT (n = 292) groups and evaluated the risk factors and antibody type (anti-A/B vs. HLA-DSA) responsible for AAMR. AAMR developed less frequently in ABOi and CONT than in the ABOi+HLAs or HLAs (P < 0.05 for all); however, there was no difference between the ABOi+HLAs and HLAs groups. AAMR developed more frequently with strong HLA-DSA at baseline; however, high baseline anti-A/B titer did not affect AAMR development. Strong baseline HLA-DSA was an independent predictor for AAMR, however the baseline anti-A/B titer was not. All four AAMR episodes in ABOi+HLAs were positive to HLA-DSA but not to anti-A/B. In conclusion, ABO incompatibility does not increase the risk for AAMR in HLAs KTRs.
ISSN:1932-6203
1932-6203
DOI:10.1371/journal.pone.0123638