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Posttransplant Allosensitization in Low Immunological Risk Kidney and Kidney-Pancreas Graft Recipients
Joint Authors
Freitas, Fátima
Cabrita, António
Dias, Leonídio
Castro Henriques, António
Fonseca, Isabel
Malheiro, Jorge
Almeida, Manuela
Beirão, Idalina
Tafulo, Sandra
Martins, La Salete
Pedroso, Sofia
Source
Issue
Vol. 2014, Issue 2014 (31 Dec. 2014), pp.1-8, 8 p.
Publisher
Hindawi Publishing Corporation
Publication Date
2014-04-15
Country of Publication
Egypt
No. of Pages
8
Main Subjects
Abstract EN
Introduction.
Posttransplantation allosensitization prevalence and effect on kidney grafts outcomes remain unsettled.
Methods.
Between 2007 and 2012, 408 patients received a primary kidney graft (with 68 patients also receiving a pancreas graft) after a negative cytotoxic crossmatch.
All patients had a pretransplant negative anti-HLA screening and 0% panel reactive antibodies.
We analyzed retrospectively the results of anti-HLA antibodies screening by Luminex assay, performed between 6 and 24 months after transplant, and searched for the risk factors for antibody positivity and its impact on kidney graft outcomes.
Results.
Anti-HLA antibodies prevalence at 6 months was 17.4%.
Previous steroid-insensitive acute rejection was the only risk factor for both anti-HLA classes detected antibodies.
Antithymocyte globulin induction was also a risk factor for anti-HLA-I antibodies.
Antibody positivity status was associated with reduced graft function at 12 months and graft survival at 5 years (91.5% versus 96.4%, P=0.03).
In multivariable Cox analysis, delayed graft function (HR = 6.1, P<0.01), HLA mismatches >3 (HR = 10.2, P=0.03), and antibody positivity for anti-HLA class II (HR = 5.1, P=0.04) or class I/II (HR = 13.8, P<0.01) were independent predictors of graft loss.
Conclusions.
Allosensitization against HLA class II±I after transplant was associated with adverse kidney graft outcomes.
A screening protocol seems advisable within the first year in low immunological risk patients.
American Psychological Association (APA)
Malheiro, Jorge& Tafulo, Sandra& Dias, Leonídio& Martins, La Salete& Fonseca, Isabel& Almeida, Manuela…[et al.]. 2014. Posttransplant Allosensitization in Low Immunological Risk Kidney and Kidney-Pancreas Graft Recipients. BioMed Research International،Vol. 2014, no. 2014, pp.1-8.
https://search.emarefa.net/detail/BIM-472391
Modern Language Association (MLA)
Malheiro, Jorge…[et al.]. Posttransplant Allosensitization in Low Immunological Risk Kidney and Kidney-Pancreas Graft Recipients. BioMed Research International No. 2014 (2014), pp.1-8.
https://search.emarefa.net/detail/BIM-472391
American Medical Association (AMA)
Malheiro, Jorge& Tafulo, Sandra& Dias, Leonídio& Martins, La Salete& Fonseca, Isabel& Almeida, Manuela…[et al.]. Posttransplant Allosensitization in Low Immunological Risk Kidney and Kidney-Pancreas Graft Recipients. BioMed Research International. 2014. Vol. 2014, no. 2014, pp.1-8.
https://search.emarefa.net/detail/BIM-472391
Data Type
Journal Articles
Language
English
Notes
Includes bibliographical references
Record ID
BIM-472391