C1q binding is not an independent risk factor for kidney allograft loss after an acute antibody-mediated rejection episode: a retrospective cohort study
| Autor: | Vincent Audard, Tomek Kofman, Julie Peltier, Isabelle Brocheriou, Dominique Desvaux, Florence Canoui-Poitrine, Juliette Parisot, Eric Rondeau, Marie Matignon, Anissa Moktefi, Philippe Lang, Caroline Suberbielle, Philippe Grimbert |
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| Rok vydání: | 2016 |
| Předmět: |
Adult
Graft Rejection Male medicine.medical_specialty Pathology 030232 urology & nephrology chemical and pharmacologic phenomena 030230 surgery Gastroenterology Serology Cohort Studies 03 medical and health sciences 0302 clinical medicine immune system diseases Isoantibodies Risk Factors Internal medicine medicine Complement C4b Humans Risk factor skin and connective tissue diseases Kidney transplantation Retrospective Studies Transplantation Kidney biology business.industry Complement C1q Retrospective cohort study Transplant glomerulopathy Middle Aged medicine.disease Kidney Transplantation Peptide Fragments Tissue Donors medicine.anatomical_structure Cohort biology.protein Female Antibody business |
| Zdroj: | Transplant international : official journal of the European Society for Organ Transplantation. 30(3) |
| ISSN: | 1432-2277 |
| Popis: | After kidney transplantation, C4d is an incomplete marker of acute antibody-mediated rejection (AMR) and C1q-binding donor-specific antibodies (DSA) have been associated with allograft survival. However, the impact on allograft survival of C1q+ DSA after clinical AMR has not been studied yet. We analysed retrospectively in clinical AMR C4d staining and C1q-binding impact on allograft survival. We compared clinical, histological and serological features of C4d- and C4d+ AMR, C1q+ and C1q- DSA AMR and analysed C4d and C1q-binding impact on allograft survival. Among 500 for-cause kidney allograft biopsies, 48 fulfilled AMR criteria. C4d+ AMR [N = 18 (37.5%)] have significantly higher number class I DSA (P = 0.02), higher microvascular score (P = 0.02) and more transplant glomerulopathy (P = 0.04). C1q+ AMR [N = 20 (44%)] presented with significantly more class I and class II DSA (P = 0.005 and 0.04) and C4d+ staining (P = 0.01). Graft losses were significantly higher in the C4d+ group (P = 0.04) but similar in C1q groups. C4d+ but not C1q+ binding was an independent risk factor for graft loss [HR = 2.65; (1.11-6.34); P = 0.028]. In our cohort of clinical AMR, C4d+ staining but not C1q+ binding is an independent risk factor for graft loss. Allograft loss and patient survival were similar in C1q+ and C1q- AMR. |
| Databáze: | OpenAIRE |
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