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: | , , , , , , , , , |
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| Dokumenttyp: | Article (Journal) |
| Sprache: | Englisch |
| Veröffentlicht: |
5 June 2016
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| 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 
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| 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 |
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| 520 | |a 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. | ||
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