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Verfasst von:Fichtner, Alexander [VerfasserIn]   i
 Süsal, Caner [VerfasserIn]   i
 Höcker, Britta [VerfasserIn]   i
 Rieger, Susanne [VerfasserIn]   i
 Waldherr, Rüdiger [VerfasserIn]   i
 Westhoff, Jens [VerfasserIn]   i
 Sander, Anja [VerfasserIn]   i
 Opelz, Gerhard [VerfasserIn]   i
 Tönshoff, Burkhard [VerfasserIn]   i
Titel:Association of C1q-fixing DSA with late graft failure in pediatric renal transplant recipients
Verf.angabe:Alexander Fichtner, Caner Süsal, Britta Höcker, Susi Rieger, Rüdiger Waldherr, Jens H. Westhoff, Anja Sander, Gerhard Opelz, Burkhard Tönshoff
E-Jahr:2016
Jahr:29 February 2016
Umfang:10 S.
Fussnoten:Gesehen am 03.12.2018
Titel Quelle:Enthalten in: Pediatric nephrology
Ort Quelle:Berlin : Springer, 1987
Jahr Quelle:2016
Band/Heft Quelle:31(2016), 7, Seite 1157-1166
ISSN Quelle:1432-198X
Abstract:BackgroundWe investigated the prognostic value of overall and complement-binding donor-specific HLA antibodies (DSA) in pediatric patients undergoing clinically indicated graft biopsies and their association with graft outcome and specific histological lesions.MethodsSera of 62 patients at time of indication biopsy ≥1 year posttransplant were assessed for DSA and C1q-fixing DSA by single-antigen bead (SAB) technology.ResultsTwenty-six patients (42 %) were DSA-positive at time of indication biopsy and nine (15 %) were C1q-positive. At 4 years postbiopsy, patients with C1q-positivity had a low graft survival (11 %) compared to DSA-positive, C1q-negative patients (82 %, p = 0.001) and to DSA-negative patients (88 %, p < 0.001). The majority (89 %) of C1q-positive patients were diagnosed with active chronic antibody-mediated rejection (ABMR). C1q DSA-positivity [adjusted hazard ratio (HR) 6.35], presence of transplant glomerulopathy (HR 9.54), and estimated glomerular filtration rate (eGFR) at the time of indication biopsy (HR 0.91) were risk factors for subsequent graft loss.ConclusionsThe presence of C1q-positive DSA in the context of an indication biopsy identifies a subgroup of pediatric renal transplant recipients with a markedly increased risk of subsequent graft loss. Because a fraction of DSA-positive patients escape rejection or graft dysfunction, the C1q assay increases the specificity of a positive DSA result regarding unfavorable transplant outcome.
DOI:doi:10.1007/s00467-016-3322-8
URL:Bitte beachten Sie: Dies ist ein Bibliographieeintrag. Ein Volltextzugriff für Mitglieder der Universität besteht hier nur, falls für die entsprechende Zeitschrift/den entsprechenden Sammelband ein Abonnement besteht oder es sich um einen OpenAccess-Titel handelt.

Volltext: http://dx.doi.org/10.1007/s00467-016-3322-8
 Volltext: https://doi.org/10.1007/s00467-016-3322-8
 DOI: https://doi.org/10.1007/s00467-016-3322-8
Datenträger:Online-Ressource
Sprache:eng
Sach-SW:C1q-binding donor-specific antibodies
 Donor-specific antibodies
 Graft failure
 Indication biopsy
 Pediatrics
 Renal transplantation
K10plus-PPN:1584730188
Verknüpfungen:→ Zeitschrift

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