Impact of de novo donor-specific HLA antibodies detected by Luminex solid phase assay after transplantation in a group of 88 consecutive living donor renal transplantations

Background : De novo donor-specific HLA antibodies (DSA) after renal transplantation are known to be correlated with poor graft outcome and the development of acute and chronic rejection. Currently, data for the influence ofde novo DSA in patient cohorts including only living donor renal transplantations (LDRT) are limited.
Methods : A consecutive cohort of 88 LDRT was tested for the occurrence of de novo DSA by utilizing the highly sensitive Luminex solid phase assay for antibody detection. Data were analyzed for risk factors of de novoDSA development and correlated with acute rejection (AR) and graft function.
Results : Patients with de novo DSA [31 (35%)] showed a trend for inferior graft function [Mean creatinine change (mg/dL/year) after the first year: 0.15 DSA (+) vs 0.02 DSA (-) (p= 0.10)] and a higher rate of AR episodes, especially in case of de novo DSA of both class I and II [6 (55%), (p= 0.05)]. Antibody mediated rejection (AMR) appeared in five patients and was significantly correlated with de novo DSA (p= 0.05).
Conclusions : Monitoring for de novo DSA after LDRT may help to identify patients at risk for declining renal function. Especially patients with simultaneous presence of de novo DSA class I and class II are at a high risk to suffer AR episodes (read more) Print this post