Pretransplant Kinetics of Anti-HLA Antibodies in Patients on the Waiting List for Kidney Transplantation
| Autor: | Jakob Nilsson, Matteo Togninalli, Karsten M. Borgwardt, Antonios G.A. Kolios, Daisuke Yoneoka |
|---|---|
| Přispěvatelé: | University of Zurich, Nilsson, Jakob |
| Rok vydání: | 2019 |
| Předmět: |
Nephrology
medicine.medical_specialty Waiting Lists 030232 urology & nephrology 610 Medicine & health Human leukocyte antigen 030230 surgery Disease cluster Organ transplantation 03 medical and health sciences 0302 clinical medicine Clinical Research Internal medicine medicine Humans Kidney transplantation Antilymphocyte Serum Pregnancy 2727 Nephrology business.industry Histocompatibility Testing Alloimmunity General Medicine medicine.disease Kidney Transplantation Kinetics Waiting list 10033 Clinic for Immunology business |
| Zdroj: | J Am Soc Nephrol Journal of the American Society of Nephrology |
| ISSN: | 1533-3450 1046-6673 |
| Popis: | Background Patients on organ transplant waiting lists are evaluated for preexisting alloimmunity to minimize episodes of acute and chronic rejection by regularly monitoring for changes in alloimmune status. There are few studies on how alloimmunity changes over time in patients on kidney allograft waiting lists, and an apparent lack of research-based evidence supporting currently used monitoring intervals. Methods To investigate the dynamics of alloimmune responses directed at HLA antigens, we retrospectively evaluated data on anti-HLA antibodies measured by the single-antigen bead assay from 627 waitlisted patients who subsequently received a kidney transplant at University Hospital Zurich, Switzerland, between 2008 and 2017. Our analysis focused on a filtered dataset comprising 467 patients who had at least two assay measurements. Results Within the filtered dataset, we analyzed potential changes in mean fluorescence intensity values (reflecting bound anti-HLA antibodies) between consecutive measurements for individual patients in relation to the time interval between measurements. Using multiple approaches, we found no correlation between these two factors. However, when we stratified the dataset on the basis of documented previous immunizing events (transplant, pregnancy, or transfusion), we found significant differences in the magnitude of change in alloimmune status, especially among patients with a previous transplant versus patients without such a history. Further efforts to cluster patients according to statistical properties related to alloimmune status kinetics were unsuccessful, indicating considerable complexity in individual variability. Conclusions Alloimmune kinetics in patients on a kidney transplant waiting list do not appear to be related to the interval between measurements, but are instead associated with alloimmunization history. This suggests that an individualized strategy for alloimmune status monitoring may be preferable to currently used intervals. |
| Databáze: | OpenAIRE |
| Externí odkaz: |
|