Donor-specific anti-HLA antibodies in pediatric renal transplant recipients with creeping creatinine: Prevalence, histological correlations, and impact on patient and graft survival

Autor:	Alicia B. Chaparro, J. Goldberg, Cintia Yanina Marcos, David N. Rush, Karim Padros, Ziomara Balbarrey, Marta Lidia Monteverde, Liliana Briones
Rok vydání:	2015
Předmět:	Graft Rejection Male medicine.medical_specialty Adolescent Kaplan-Meier Estimate Gastroenterology chemistry.chemical_compound HLA Antigens Isoantibodies Internal medicine Biopsy medicine Humans Hla antibodies In patient Child Kidney transplantation Proportional Hazards Models Transplantation Creatinine medicine.diagnostic_test business.industry Graft Survival medicine.disease Kidney Transplantation Surgery body regions chemistry Renal transplant Child Preschool Histocompatibility Pediatrics Perinatology and Child Health Female Histopathology Graft survival business Biomarkers Follow-Up Studies
Zdroj:	Pediatric Transplantation. 19:684-690
ISSN:	1397-3142
Popis:	Donor-specific anti-HLA antibodies (DSA) causing CAMR are responsible for a high proportion of long-term graft failures after RTX. We studied the prevalence of DSA in RTX children biopsied for creeping Cr, its relationship with NA, and patient and graft survival according to histopathology. Between 2008 and 2013, 92 children were biopsied at a median of 38 months post-RTX. At biopsy, the prevalence of DSA was 49% and C4d 70%. NA rate was 45%, higher in adolescents (60%). Most frequent diagnoses were CAMR (72%) and interstitial fibrosis with tubular atrophy (IFTA) (28%). Forty-five of 66 patients with CAMR (68%) had detectable DSA. Twenty-one DSA-negative patients with CAMR had histological damage (IFTA + C4d positivity). C4d was detected in 64 of 66 biopsies with CAMR. Recipients with IFTA alone had neither C4d, nor detectable DSA, and were adherent. Graft survival at five yr was 89% in patients with CAMR, 79% in those with CAMR + TCMR Banff I, 33% in those with CAMR + TCMR Banff II, and 96% in those with IFTA. ABMR and complement activation were frequent in children biopsied for creeping Cr. Recipients with DSA were more likely to be non-adherent and have CAMR or CAMR + TCMR and worse graft survival.
Databáze:	OpenAIRE
Externí odkaz:	https://explore.openaire.eu/search/publication?articleId=doi_dedup___::b3f42b7a5fb8851cfa0c3277ddce91bc https://doi.org/10.1111/petr.12556 Zobrazit plný text záznamu Plný text ve formátu PDF Plný text ve formátu HTML
Nepřihlášeným uživatelům se plný text nezobrazuje	K zobrazení výsledku je třeba se přihlásit.