Donor-specific antibodies require preactivated immune system to harm renal transplant

• Verfasst von: Süsal, Caner [VerfasserIn]
• Verfasst von: Döhler, Bernd [VerfasserIn]
• Verfasst von: Ruhenstroth, Andrea [VerfasserIn]
• Verfasst von: Morath, Christian [VerfasserIn]
• Verfasst von: Scherer, Sabine [VerfasserIn]
• Verfasst von: Tran, Thuong Hien [VerfasserIn]
• Verfasst von: Gombos, Petra [VerfasserIn]
• Verfasst von: Schemmer, Peter [VerfasserIn]
• Verfasst von: Zeier, Martin [VerfasserIn]
• Verfasst von: Opelz, Gerhard [VerfasserIn]
• Titel: Donor-specific antibodies require preactivated immune system to harm renal transplant
• Verf.angabe: Caner Süsal, Bernd Döhler, Andrea Ruhenstroth, Christian Morath, Antonij Slavcev, Thomas Fehr, Eric Wagner, Bernd Krüger, Margaret Rees, Sanja Balen, Stela Živčić-Ćosić, Douglas J. Norman, Dirk Kuypers, Marie-Paule Emonds, Przemyslaw Pisarski, Claudia Bösmüller, Rolf Weimer, Joannis Mytilineos, Sabine Scherer, Thuong H. Tran, Petra Gombos, Peter Schemmer, Martin Zeier, Gerhard Opelz, a Collaborative Transplant Study report
• E-Jahr: 2016
• Jahr: 5 June 2016
• Umfang: 6 S.
• Fussnoten: Gesehen am 26.05.2020
• Titel Quelle: Enthalten in: EBioMedicine
• Ort Quelle: Amsterdam [u.a.] : Elsevier, 2014
• Jahr Quelle: 2016
• Band/Heft Quelle: 9(2016), Seite 366-371
• ISSN Quelle: 2352-3964
• DOI: doi:10.1016/j.ebiom.2016.06.006
• Datenträger: Online-Ressource
• Sprache: eng
• Sach-SW: Donor-specific antibodies
• Sach-SW: Graft outcome
• Sach-SW: HLA antibodies
• Sach-SW: Kidney transplantation
• Sach-SW: sCD30
• Sach-SW: Single antigen bead
• K10plus-PPN: 169882694X

Abstract

Background - It is an unresolved issue why some kidney transplant recipients with pretransplant donor-specific HLA antibodies (DSA) show a high transplant failure rate, whereas in other patients DSA do not harm the graft. We investigated whether help from preactivated T-cells might be necessary for DSA to exert a deleterious effect. - Methods - The impact of pretransplant DSA and immune activation marker soluble CD30 (sCD30) on 3-year graft survival was analyzed in 385 presensitized kidney transplant recipients. - Findings - A deleterious influence of pretransplant DSA on graft survival was evident only in patients who were positive for the immune activation marker sCD30. In the absence of sCD30 positivity, 3-year graft survival was virtually identical in patients with or without DSA (83.1±3.9% and 84.3±2.8%, P=0.81). A strikingly lower 3-year graft survival rate of 62.1±6.4% was observed in patients who were both sCD30 and DSA positive (HR 2.92, P<0.001). Even in the presence of strong DSA with ≥5000 MFI, the 3-year graft survival rate was high if the recipients were sCD30 negative. - Interpretation - Pretransplant DSA have a significantly deleterious impact on graft survival only in the presence of high pretransplant levels of the activation marker sCD30.