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

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...

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Hauptverfasser: Süsal, Caner (VerfasserIn) , Döhler, Bernd (VerfasserIn) , Ruhenstroth, Andrea (VerfasserIn) , Morath, Christian (VerfasserIn) , Scherer, Sabine (VerfasserIn) , Tran, Thuong Hien (VerfasserIn) , Gombos, Petra (VerfasserIn) , Schemmer, Peter (VerfasserIn) , Zeier, Martin (VerfasserIn) , Opelz, Gerhard (VerfasserIn)
Dokumenttyp: Article (Journal)
Sprache:Englisch
Veröffentlicht: 5 June 2016
In: EBioMedicine
Year: 2016, Jahrgang: 9, Pages: 366-371
ISSN:2352-3964
DOI:10.1016/j.ebiom.2016.06.006
Online-Zugang:Verlag, lizenzpflichtig, Volltext: https://doi.org/10.1016/j.ebiom.2016.06.006
Verlag, lizenzpflichtig, Volltext: http://www.sciencedirect.com/science/article/pii/S235239641630250X
Volltext
Verfasserangaben: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
Beschreibung
Zusammenfassung: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.
Beschreibung:Gesehen am 26.05.2020
Beschreibung:Online Resource
ISSN:2352-3964
DOI:10.1016/j.ebiom.2016.06.006

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