IgG3 donor‐specific antibodies with a proinflammatory glycosylation profile may be associated with the risk of antibody‐mediated rejection after kidney transplantation

De novo donor-specific antibodies (dnDSA) are associated with antibody-mediated rejection (ABMR) and allograft loss. We tested Immucor* (IM) Luminex Single-antigen beads (LSAB) assay and C3d-fixing antibodies in the setting of dnDSA and subclinical (s) ABMR. This retrospective multicentric study included 123 patients biopsied because of the presence of subclinical de novo DSA detected by One Lamda* Labscreen (MFI > 1000). In 112 patients, sera of the day of the biopsy were available and tested in a central lab with IM Lifecodes LSAB and C3d fixing antibodies assays. In 16 patients (14.3%), no DSA was detected using Immucor test. In 96 patients, at least one DSA was determined with IM. Systematic biopsies showed active sABMR in 30 patients (31.2%), chronic active sABMR in 17 patients (17.7%) and no lesions of sABMR in 49 KT recipients (51%). Intensitity criteria (BCM, BCR and AD-BCR) of DSA were not statistically different between these 3 histological groups. The proportion of patients with C3d-fixing DSA was not statistically different between the 3 groups and did not offer any prognostic value regarding graft survival. Performing biopsy for dnDSA could not be guided by the intensity criteria of IM LSAB assay. C3d-fixing DSA do not offer added value.

Download Full-text

Antibody-Mediated Rejection With and Without HLA Donor-Specific Antibodies in Kidney-Transplantation

Transplantation Journal ◽

10.1097/01.tp.0000542869.07515.27 ◽

2018 ◽

Vol 102 ◽

pp. S211-S212 ◽

Cited By ~ 1

Author(s):

Marta Crespo ◽

Dolores Redondo ◽

Carrie Butler ◽

Javier Gimeno ◽

Carme Garcia ◽

...

Keyword(s):

Kidney Transplantation ◽

Specific Antibodies ◽

Antibody Mediated Rejection ◽

Donor Specific Antibodies

Download Full-text

Safety and efficacy of eculizumab for the prevention of antibody‐mediated rejection after deceased‐donor kidney transplantation in patients with preformed donor‐specific antibodies

American Journal of Transplantation ◽

10.1111/ajt.15397 ◽

2019 ◽

Vol 19 (10) ◽

pp. 2865-2875 ◽

Cited By ~ 21

Author(s):

Denis Glotz ◽

Graeme Russ ◽

Lionel Rostaing ◽

Christophe Legendre ◽

Gunnar Tufveson ◽

...

Keyword(s):

Kidney Transplantation ◽

Deceased Donor ◽

Donor Kidney ◽

Safety And Efficacy ◽

Specific Antibodies ◽

Antibody Mediated Rejection ◽

Deceased Donor Kidney ◽

Donor Specific Antibodies ◽

Donor Kidney Transplantation ◽

Deceased Donor Kidney Transplantation

Download Full-text

ABO-incompatibility and donor-specific antibodies existence effect on antibody-mediated rejection in kidney transplantation

Korean Journal of Transplantation ◽

10.4285/atw2021.op-1066 ◽

2021 ◽

Vol 35 (1) ◽

pp. S81-S81

Author(s):

Kwang Woo Choi ◽

Sangil Min ◽

Eun-Ah Jo ◽

Ahram Han ◽

Sanghyun Ahn ◽

...

Keyword(s):

Kidney Transplantation ◽

Specific Antibodies ◽

Antibody Mediated Rejection ◽

Abo Incompatibility ◽

Donor Specific Antibodies

Download Full-text

Clinical Case: Patient with Mixed Graft Rejection Four Days after Kidney Transplantation Developed Specific Antibodies against Donor Bw4 Specificities

Antibodies ◽

10.3390/antib10030028 ◽

2021 ◽

Vol 10 (3) ◽

pp. 28

Author(s):

Claudia M. Muñoz-Herrera ◽

Juan Francisco Gutiérrez-Bautista ◽

Miguel Ángel López-Nevot

Keyword(s):

Kidney Transplantation ◽

Graft Rejection ◽

Human Leukocyte ◽

Case Patient ◽

Specific Antibodies ◽

Antibody Mediated Rejection ◽

Leukocyte Antigens ◽

Hla Genotypes ◽

Donor Specific Antibodies ◽

Hla Genotype

Kidney transplantation, like other transplants, has the risk of producing graft rejection due to genetic differences between donor and recipient. The three known types of renal rejection are listed in the Banff classification: T-cell-mediated rejection (TCMR), antibody-mediated rejection (ABMR), and mixed rejection. The human leukocyte antigens (HLA) are highly polymorphic and may be the targets of donor-specific antibodies, resulting in ABMR. Therefore, prior to transplantation, it is necessary to analyze the HLA genotype of the donor and recipient, as well as the presence of DSA, in order to avoid hyperacute rejection. However, due to the shortage of kidneys, it is very difficult to find a donor and a recipient with completely matched HLA genotypes. This can trigger a future rejection of the kidney, as is reported in this work. We describe a patient who received a kidney transplant after a negative DSA test, who developed graft rejection with antibodies against the donor’s HLA-Bw4 public epitope and lymphocytic infiltrate four days after transplantation, whose differential diagnosis was mixed rejection.

Download Full-text

The gray area between operational tolerance and overt rejection in kidney transplantation

Portuguese Journal of Nephrology & Hypertension ◽

10.32932/pjnh.2021.12.162 ◽

2022 ◽

Vol 35 (4) ◽

Author(s):

Rui Silva ◽

◽

Miguel Relvas ◽

Ana Nunes ◽

José Silvano ◽

...

Keyword(s):

Kidney Transplantation ◽

Serum Creatinine ◽

Specific Antibodies ◽

Antibody Mediated Rejection ◽

Early Lesions ◽

Gray Area ◽

Operational Tolerance ◽

Donor Specific Antibodies ◽

One Year ◽

Tolerance Criteria

Operational tolerance in kidney transplantation is characterized by stable serum creatinine < 1.7 mg/dL and proteinuria < 1 g/day in the absence of immunosuppression or immunodeficiency for over one year. However, simultaneous donor specific antibodies are common and serum creatinine is a poor surrogate of early lesions. Consequently, subclinical rejections will meet operational tolerance criteria if serum creatinine remains stable. We report a patient with operational tolerance criteria followed by biopsy-proven chronic active antibody mediated rejection, discussing the intricate challenges of immunosuppression management.

Download Full-text