scholarly journals Donor-specific and -nonspecific HLA antibodies and outcome post lung transplantation

2017 ◽  
Vol 50 (5) ◽  
pp. 1701248 ◽  
Author(s):  
Stijn E. Verleden ◽  
Bart M. Vanaudenaerde ◽  
Marie-Paul Emonds ◽  
Dirk E. Van Raemdonck ◽  
Arne P. Neyrinck ◽  
...  
Keyword(s):  
Lung Transplantation ◽  
Graft Survival ◽  
Human Leukocyte ◽  
Term Outcome ◽  
Hla Antibodies ◽  
Long Term Outcome ◽  
Leukocyte Antigen ◽  
Post Transplant ◽  
Antibody Mediated Rejection ◽  
Hla Dq

Donor-specific antibodies (DSAs) against human leukocyte antigen (HLA) are associated with chronic lung allograft dysfunction (CLAD) and mortality post lung transplantation, but data concerning prevalence, time of onset, persistence and effects on long-term outcome remain scarce.We assessed the association between HLA antibodies and CLAD-free and graft survival in a cohort of 362 patients. We stratified our analysis according to DSA status, persistence of antibodies and timing of antibodies (pre-transplant, early or late post-transplant).Within our cohort, 61 (17%) patients developed DSAs (mostly against HLA-DQ), which was associated with worse CLAD-free and graft survival (p<0.0001 and p=0.059, respectively). Persistent (hazard ratio (HR) 3.386, 95% CI 1.928–5.948; p<0.0001) as well as transient (HR 2.998, 95% CI 1.406–6.393; p=0.0045) DSAs were associated with shorter CLAD-free survival compared with patients without DSAs. Persistent DSAs (HR 3.071, 95% CI 1.632–5.778; p=0.0005) but not transient DSAs were negatively associated with graft survival compared with patients without DSAs, likely due to the higher incidence of restrictive CLAD. HLA non-DSAs and pre-transplant HLA antibodies had no effect on post-transplant outcome.We demonstrated an important difference in prognosis between persistent and transient DSAs. Moreover, the observed association between DSAs and restrictive CLAD suggests an overlap between antibody-mediated rejection and restrictive CLAD that needs further investigation.

Impact of human leukocyte antigen (HLA) matching on graft survival after lung transplantation

2002 ◽  
Vol 21 (1) ◽  
pp. 169-170
Author(s):  
P.S Neuhauser ◽  
A Kocher ◽  
P Jaksch ◽  
T Wekerle ◽  
W Klepetko ◽  
...  
Keyword(s):  
Lung Transplantation ◽  
Human Leukocyte Antigen ◽  
Graft Survival ◽  
Human Leukocyte ◽  
Hla Matching ◽  
Leukocyte Antigen

scholarly journals The Assessment of HLA Sensitization Effect on Graft Function and Survival in Renal Transplant Recipients

2021 ◽  
Author(s):  
Derya Güleç ◽  
Tülay Kılıçaslan Ayna ◽  
Mustafa Soyöz ◽  
İsmail Sert ◽  
Cem Tuğmen ◽  
...  
Keyword(s):  
Graft Survival ◽  
Cox Regression ◽  
Patient Survival ◽  
Graft Function ◽  
Human Leukocyte ◽  
Hla Class I ◽  
Acute Rejection Episode ◽  
Renal Transplant Recipients ◽  
Hla Antibodies ◽  
Post Transplant

Objective: Anti-human leukocyte antibodies (HLA) play an important role in graft survival, particularly in kidney transplantation. Preformed anti-HLA antibodies, especially donor specific antibodies can cause acute and chronic rejections. In this study, it was aimed to assess the effects of anti-HLA antibodies in kidney patients before transplant on graft function, failure, and patient survival. Methods: PRA (Panel Reactive Antibody) levels were monitored using bead based methods such as Luminex and flow cytometry. Post-transplant estimated glomerular filtration ratios (eGFR) among first, third, and fifth year patient survivals and graft failures were statistically analyzed. Results: In this study, it was observed that related transplants had low levels of PRAs, and their eGFRs were at normal reference range. The patients without acute rejection episode (ARE) had higher eGFR values than those with ARE. When five year-graft survival terms were evaluated, it was found that 65.6±9.8% and 86.5±3.2% graft survival terms were detected in anti-HLA Class I/II positive and negative patients, whereas 74.8±6.4% and 84.3 ±2.6% graft survival terms were observed in ARE positive and negative patients, respectively. eGFR value is a predictor of graft failure and patient survival. Our Cox regression analyses (HR=0.843, p=0.00) also supported this information. Conclusion: The study concluded that although the correlation between PRA positivity and graft survival were not significant, the shortest graft survival was observed in PRA positive patients in the whole cohort and ARE positive patients. The importance and requirement of pre- and post-transplant PRA tests continue.

scholarly journals Relationship between early proteinuria and long term outcome of kidney transplanted patients from different decades of donor age

2019 ◽  
Author(s):  
Davide Diena ◽  
Maria Messina ◽  
Consuelo De Biase ◽  
Fabrizio Fop ◽  
Edoardo Scardino ◽  
...  
Keyword(s):  
Graft Survival ◽  
Age Groups ◽  
Graft Function ◽  
Significant Risk ◽  
Low Grade ◽  
Donor Age ◽  
Term Outcome ◽  
Long Term Outcome ◽  
Post Transplant ◽  
The Impact

Abstract Background Proteinuria after kidney transplantation portends a worse graft survival. However the magnitude of proteinuria related to patient and graft survival and its correlation with donor and recipient characteristics are poorly explored. Methods This study investigated the impact of post transplant proteinuria in the first year in 1127 kidney transplants analyzing the impact of different donor ages. Proteinuria cut off was set at 0.5 g/day. Results Transplants with proteinuria > 0.5 g/day correlated with poor graft and patient outcome in all donor age groups. In addition, 6-month-1-year proteinuria increase was significantly associated with graft outcome, especially with donors > 60 years old (p < 0.05; Odd Ratio 1.8). 1-year graft function (eGFR < or ≥44 ml/min) had similar impact to proteinuria (≥ 0.5 g/day) on graft failure (HR 2.77 vs HR 2.46). Low-grade proteinuria (0.2-0.5 g/day) demonstrated a trend for worse graft survival with increasing donor age. Also in kidney-paired analysis proteinuria ≥ 0.5 effect was more significant with donors >50 years old (OR 2.3). Conclusions Post-transplant proteinuria was increasingly harmful with older donor age. Proteinuria ≥ 0.5 g/day correlates with worse outcomes in all transplanted patients. Prognostic value of proteinuria and eGFR for graft and patient survival was comparable and these two variables remain significant risk factors even in a multivariate model that take into consideration the most important clinical variables (donor age, rejection, delayed graft function and cytomegalovirus viremia among others).

scholarly journals Relationship between early proteinuria and long term outcome of kidney transplanted patients from different decades of donor age

2019 ◽  
Vol 20 (1) ◽  
Author(s):  
Davide Diena ◽  
Maria Messina ◽  
Consuelo De Biase ◽  
Fabrizio Fop ◽  
Edoardo Scardino ◽  
...  
Keyword(s):  
Graft Survival ◽  
Graft Function ◽  
Significant Risk ◽  
Hazard Ratio ◽  
Low Grade ◽  
Donor Age ◽  
Term Outcome ◽  
Long Term Outcome ◽  
Post Transplant ◽  
The Impact

Abstract Background Proteinuria after kidney transplantation portends a worse graft survival. However the magnitude of proteinuria related to patient and graft survival and its correlation with donor and recipient characteristics are poorly explored. Methods This study investigated the impact of post transplant proteinuria in the first year in 1127 kidney transplants analyzing the impact of different donor ages. Proteinuria cut off was set at 0.5 g/day. Results Transplants with proteinuria > 0.5 g/day correlated with poor graft and patient outcome in all donor age groups. In addition, 6-month-1-year proteinuria increase was significantly associated with graft outcome, especially with donors > 60 years old (p <  0.05; Odd Ratio 1.8). 1-year graft function (eGFR < or ≥ 44 ml/min) had similar impact to proteinuria (≥ 0.5 g/day) on graft failure (Hazard Ratio 2.77 vs Hazard Ratio 2.46). Low-grade proteinuria (0.2–0.5 g/day) demonstrated a trend for worse graft survival with increasing donor age. Also in kidney-paired analysis proteinuria ≥0.5 effect was more significant with donors > 50 years old (Odd Ratio 2.3). Conclusions Post-transplant proteinuria was increasingly harmful with older donor age. Proteinuria ≥0.5 g/day correlates with worse outcomes in all transplanted patients. Prognostic value of proteinuria and eGFR for graft and patient survival was comparable and these two variables remain significant risk factors even in a multivariate model that take into consideration the most important clinical variables (donor age, rejection, delayed graft function and cytomegalovirus viremia among others).

scholarly journals Transplant Glomerulopathy: The Interaction of HLA Antibodies and Endothelium

2014 ◽  
Vol 2014 ◽  
pp. 1-11 ◽  
Author(s):  
William Hanf ◽  
Claudine S. Bonder ◽  
P. Toby H. Coates
Keyword(s):  
Endothelial Cells ◽  
Endothelial Cell ◽  
Cell Injury ◽  
Human Leukocyte ◽  
Hla Antibodies ◽  
Endothelial Cell Injury ◽  
Leukocyte Antigen ◽  
Antibody Mediated Rejection ◽  
Definition Of ◽  
Transplant Glomerulopathy

Transplant glomerulopathy (TG) is a major cause of chronic graft dysfunction without effective therapy. Although the histological definition of TG is well characterized, the pathophysiological pathways leading to TG development are still poorly understood. Electron microscopy suggests an earlier appearance of TG and suggests that endothelial cell injury is the first sign of the disease. The pathogenic role of human leukocyte antigen (HLA) antibodies in endothelial cells has been described in acute vascular and humoral rejection. However the mechanisms and pathways of endothelial cell injury by HLA antibodies remain unclear. Despite the description of different causes of the morphological lesion of TG (hepatitis, thrombotic microangiopathy), the strong link between TG and chronic antibody mediated rejection suggests a major role for HLA antibodies in TG formation. In this review, we describe the effect of classes I or II HLA-antibodies in TG and especially the implication of donor specific antibodies (DSA). We update recent studies about endothelial cells and try to explain the different signals and intracellular pathways involved in the progression of TG.

scholarly journals Relationship between early proteinuria and long term outcome of kidney transplanted patients from different decades of donor age

2019 ◽  
Author(s):  
Davide Diena ◽  
Maria Messina ◽  
Consuelo De Biase ◽  
Fabrizio Fop ◽  
Edoardo Scardino ◽  
...  
Keyword(s):  
Graft Survival ◽  
Age Groups ◽  
Graft Function ◽  
Significant Risk ◽  
Low Grade ◽  
Donor Age ◽  
Term Outcome ◽  
Long Term Outcome ◽  
Post Transplant ◽  
The Impact

Abstract Background Proteinuria after kidney transplantation portends a worse graft survival. However the magnitude of proteinuria related to patient and graft survival and its correlation with donor and recipient characteristics are poorly explored. Methods This study investigated the impact of post transplant proteinuria in the first year in 1127 kidney transplants analyzing the impact of different donor ages. Proteinuria cut off was set at 0.5 g/day. Results Transplants with proteinuria > 0.5 g/day correlated with poor graft and patient outcome in all donor age groups. In addition, 6-month-1-year proteinuria increase was significantly associated with graft outcome, especially with donors > 60 years old (p < 0.05; Odd Ratio 1.8). 1-year graft function (eGFR < or ≥44 ml/min) had similar impact to proteinuria (≥ 0.5 g/day) on graft failure (HR 2.77 vs HR 2.46). Low-grade proteinuria (0.2-0.5 g/day) demonstrated a trend for worse graft survival with increasing donor age. Also in kidney-paired analysis proteinuria ≥ 0.5 effect was more significant with donors >50 years old (OR 2.3). Conclusions Post-transplant proteinuria was increasingly harmful with older donor age. Proteinuria ≥ 0.5 g/day correlates with worse outcomes in all transplanted patients. Prognostic value of proteinuria and eGFR for graft and patient survival was comparable and these two variables remain significant risk factors even in a multivariate model that take into consideration the most important clinical variables (donor age, rejection, delayed graft function and cytomegalovirus viremia among others).

scholarly journals Relationship between early proteinuria and long term outcome of kidney transplanted patients from different decades of donor age

2019 ◽  
Author(s):  
Davide Diena ◽  
Maria Messina ◽  
Consuelo De Biase ◽  
Fabrizio Fop ◽  
Edoardo Scardino ◽  
...  
Keyword(s):  
Graft Survival ◽  
Age Groups ◽  
Graft Function ◽  
Significant Risk ◽  
Low Grade ◽  
Donor Age ◽  
Term Outcome ◽  
Long Term Outcome ◽  
Post Transplant ◽  
The Impact

Abstract Background Proteinuria after kidney transplantation portends a worse graft survival. However the magnitude of proteinuria related to patient and graft survival and its correlation with donor and recipient characteristics are poorly explored. Methods This study investigated the impact of post transplant proteinuria in the first year in 1127 kidney transplants analyzing the impact of different donor ages. Proteinuria cut off was set at 0.5 g/day. Results Transplants with proteinuria > 0.5 g/day correlated with poor graft and patient outcome in all donor age groups. In addition, 6-month-1-year proteinuria increase was significantly associated with graft outcome, especially with donors > 60 years old (p < 0.05; Odd Ratio 1.8). 1-year graft function (eGFR < or ≥44 ml/min) had similar impact to proteinuria (≥ 0.5 g/day) on graft failure (HR 2.77 vs HR 2.46). Low-grade proteinuria (0.2-0.5 g/day) demonstrated a trend for worse graft survival with increasing donor age. Also in kidney-paired analysis proteinuria ≥ 0.5 effect was more significant with donors >50 years old (OR 2.3). Conclusions Post-transplant proteinuria was increasingly harmful with older donor age. Proteinuria ≥ 0.5 g/day correlates with worse outcomes in all transplanted patients. Prognostic value of proteinuria and eGFR for graft and patient survival was comparable and these two variables remain significant risk factors even in a multivariate model that take into consideration the most important clinical variables (donor age, rejection, delayed graft function and cytomegalovirus viremia among others).

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