Differential effects of donor-specific HLA antibodies in living versus deceased donor transplant

E. G. Kamburova; B. W. Wisse; I. Joosten; W. A. Allebes; A. van der Meer; L. B. Hilbrands; M. C. Baas; E. Spierings; C. E. Hack; F. E. van Reekum; A. D. van Zuilen; M. C. Verhaar; M. L. Bots; A. C. A. D. Drop; L. Plaisier; M. A. J. Seelen; J. S. F. Sanders; B. G. Hepkema; A. J. A. Lambeck; L. B. Bungener; C. Roozendaal; M. G. J. Tilanus; C. E. Voorter; L. Wieten; E. M. van Duijnhoven; M. Gelens; M. H. L. Christiaans; F. J. van Ittersum; S. A. Nurmohamed; N. M. Lardy; W. Swelsen; K. A. van der Pant; N. C. van der Weerd; I. J. M. ten Berge; F. J. Bemelman; A. Hoitsma; P. J. M. van der Boog; J. W. de Fijter; M. G. H. Betjes; S. Heidt; D. L. Roelen; F. H. Claas; H. G. Otten

doi:10.1111/ajt.14709

Differential effects of donor-specific HLA antibodies in living versus deceased donor transplant

E. G. Kamburova^*, B. W. Wisse, I. Joosten, W. A. Allebes, A. van der Meer, L. B. Hilbrands, M. C. Baas, E. Spierings, C. E. Hack, F. E. van Reekum, A. D. van Zuilen, M. C. Verhaar, M. L. Bots, A. C. A. D. Drop, L. Plaisier, M. A. J. Seelen, J. S. F. Sanders, B. G. Hepkema, A. J. A. Lambeck, L. B. BungenerC. Roozendaal, M. G. J. Tilanus, C. E. Voorter, L. Wieten, E. M. van Duijnhoven, M. Gelens, M. H. L. Christiaans, F. J. van Ittersum, S. A. Nurmohamed, N. M. Lardy, W. Swelsen, K. A. van der Pant, N. C. van der Weerd, I. J. M. ten Berge, F. J. Bemelman, A. Hoitsma, P. J. M. van der Boog, J. W. de Fijter, M. G. H. Betjes, S. Heidt, D. L. Roelen, F. H. Claas, H. G. Otten

^*Corresponding author for this work

Research output: Contribution to journal › Article › Academic › peer-review

Abstract

The presence of donor-specific anti-HLA antibodies (DSAs) is associated with increased risk of graft failure after kidney transplant. We hypothesized that DSAs against HLA class I, class II, or both classes indicate a different risk for graft loss between deceased and living donor transplant. In this study, we investigated the impact of pretransplant DSAs, by using single antigen bead assays, on long-term graft survival in 3237 deceased and 1487 living donor kidney transplants with a negative complement-dependent crossmatch. In living donor transplants, we found a limited effect on graft survival of DSAs against class I or II antigens after transplant. Class I and II DSAs combined resulted in decreased 10-year graft survival (84% to 75%). In contrast, after deceased donor transplant, patients with class I or class II DSAs had a 10-year graft survival of 59% and 60%, respectively, both significantly lower than the survival for patients without DSAs (76%). The combination of class I and II DSAs resulted in a 10-year survival of 54% in deceased donor transplants. In conclusion, class I and II DSAs are a clear risk factor for graft loss in deceased donor transplants, while in living donor transplants, class I and II DSAs seem to be associated with an increased risk for graft failure, but this could not be assessed due to their low prevalence. Via a retrospective multicenter study, the authors investigate the impact of pretransplant donor-specific HLA antibodies on long-term graft survival in deceased and living donor kidney transplantations.

Original language	English
Pages (from-to)	2274-2284
Number of pages	11
Journal	American Journal of Transplantation
Volume	18
Issue number	9
DOIs	https://doi.org/10.1111/ajt.14709
Publication status	Published - 1 Sept 2018

Keywords

alloantibody
clinical research
practice
graft survival
kidney failure
injury
kidney transplantation
nephrology
living donor
HIGHLY SENSITIZED PATIENTS
HUMAN-LEUKOCYTE ANTIGEN
LONG-TERM OUTCOMES
KIDNEY-TRANSPLANTATION
CROSS-MATCH
RENAL-TRANSPLANTATION
SINGLE-CENTER
GRAFT LOSS
REJECTION
RISK

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Kamburova, E. G., Wisse, B. W., Joosten, I., Allebes, W. A., van der Meer, A., Hilbrands, L. B., Baas, M. C., Spierings, E., Hack, C. E., van Reekum, F. E., van Zuilen, A. D., Verhaar, M. C., Bots, M. L., Drop, A. C. A. D., Plaisier, L., Seelen, M. A. J., Sanders, J. S. F., Hepkema, B. G., Lambeck, A. J. A., ... Otten, H. G. (2018). Differential effects of donor-specific HLA antibodies in living versus deceased donor transplant. American Journal of Transplantation, 18(9), 2274-2284. https://doi.org/10.1111/ajt.14709

@article{b916f3d674674278b2b78a119c6f2482,

title = "Differential effects of donor-specific HLA antibodies in living versus deceased donor transplant",

abstract = "The presence of donor-specific anti-HLA antibodies (DSAs) is associated with increased risk of graft failure after kidney transplant. We hypothesized that DSAs against HLA class I, class II, or both classes indicate a different risk for graft loss between deceased and living donor transplant. In this study, we investigated the impact of pretransplant DSAs, by using single antigen bead assays, on long-term graft survival in 3237 deceased and 1487 living donor kidney transplants with a negative complement-dependent crossmatch. In living donor transplants, we found a limited effect on graft survival of DSAs against class I or II antigens after transplant. Class I and II DSAs combined resulted in decreased 10-year graft survival (84% to 75%). In contrast, after deceased donor transplant, patients with class I or class II DSAs had a 10-year graft survival of 59% and 60%, respectively, both significantly lower than the survival for patients without DSAs (76%). The combination of class I and II DSAs resulted in a 10-year survival of 54% in deceased donor transplants. In conclusion, class I and II DSAs are a clear risk factor for graft loss in deceased donor transplants, while in living donor transplants, class I and II DSAs seem to be associated with an increased risk for graft failure, but this could not be assessed due to their low prevalence. Via a retrospective multicenter study, the authors investigate the impact of pretransplant donor-specific HLA antibodies on long-term graft survival in deceased and living donor kidney transplantations.",

keywords = "alloantibody, clinical research, practice, graft survival, kidney failure, injury, kidney transplantation, nephrology, living donor, HIGHLY SENSITIZED PATIENTS, HUMAN-LEUKOCYTE ANTIGEN, LONG-TERM OUTCOMES, KIDNEY-TRANSPLANTATION, CROSS-MATCH, RENAL-TRANSPLANTATION, SINGLE-CENTER, GRAFT LOSS, REJECTION, RISK",

author = "Kamburova, {E. G.} and Wisse, {B. W.} and I. Joosten and Allebes, {W. A.} and {van der Meer}, A. and Hilbrands, {L. B.} and Baas, {M. C.} and E. Spierings and Hack, {C. E.} and {van Reekum}, {F. E.} and {van Zuilen}, {A. D.} and Verhaar, {M. C.} and Bots, {M. L.} and Drop, {A. C. A. D.} and L. Plaisier and Seelen, {M. A. J.} and Sanders, {J. S. F.} and Hepkema, {B. G.} and Lambeck, {A. J. A.} and Bungener, {L. B.} and C. Roozendaal and Tilanus, {M. G. J.} and Voorter, {C. E.} and L. Wieten and {van Duijnhoven}, {E. M.} and M. Gelens and Christiaans, {M. H. L.} and {van Ittersum}, {F. J.} and Nurmohamed, {S. A.} and Lardy, {N. M.} and W. Swelsen and {van der Pant}, {K. A.} and {van der Weerd}, {N. C.} and {ten Berge}, {I. J. M.} and Bemelman, {F. J.} and A. Hoitsma and {van der Boog}, {P. J. M.} and {de Fijter}, {J. W.} and Betjes, {M. G. H.} and S. Heidt and Roelen, {D. L.} and Claas, {F. H.} and Otten, {H. G.}",

year = "2018",

month = sep,

day = "1",

doi = "10.1111/ajt.14709",

language = "English",

volume = "18",

pages = "2274--2284",

journal = "American Journal of Transplantation",

issn = "1600-6135",

publisher = "Wiley",

number = "9",

}

Kamburova, EG, Wisse, BW, Joosten, I, Allebes, WA, van der Meer, A, Hilbrands, LB, Baas, MC, Spierings, E, Hack, CE, van Reekum, FE, van Zuilen, AD, Verhaar, MC, Bots, ML, Drop, ACAD, Plaisier, L, Seelen, MAJ, Sanders, JSF, Hepkema, BG, Lambeck, AJA, Bungener, LB, Roozendaal, C, Tilanus, MGJ, Voorter, CE , Wieten, L , van Duijnhoven, EM , Gelens, M , Christiaans, MHL, van Ittersum, FJ, Nurmohamed, SA, Lardy, NM, Swelsen, W, van der Pant, KA, van der Weerd, NC, ten Berge, IJM, Bemelman, FJ, Hoitsma, A, van der Boog, PJM, de Fijter, JW, Betjes, MGH, Heidt, S, Roelen, DL, Claas, FH & Otten, HG 2018, 'Differential effects of donor-specific HLA antibodies in living versus deceased donor transplant', American Journal of Transplantation, vol. 18, no. 9, pp. 2274-2284. https://doi.org/10.1111/ajt.14709

TY - JOUR

T1 - Differential effects of donor-specific HLA antibodies in living versus deceased donor transplant

AU - Kamburova, E. G.

AU - Wisse, B. W.

AU - Joosten, I.

AU - Allebes, W. A.

AU - van der Meer, A.

AU - Hilbrands, L. B.

AU - Baas, M. C.

AU - Spierings, E.

AU - Hack, C. E.

AU - van Reekum, F. E.

AU - van Zuilen, A. D.

AU - Verhaar, M. C.

AU - Bots, M. L.

AU - Drop, A. C. A. D.

AU - Plaisier, L.

AU - Seelen, M. A. J.

AU - Sanders, J. S. F.

AU - Hepkema, B. G.

AU - Lambeck, A. J. A.

AU - Bungener, L. B.

AU - Roozendaal, C.

AU - Tilanus, M. G. J.

AU - Voorter, C. E.

AU - Wieten, L.

AU - van Duijnhoven, E. M.

AU - Gelens, M.

AU - Christiaans, M. H. L.

AU - van Ittersum, F. J.

AU - Nurmohamed, S. A.

AU - Lardy, N. M.

AU - Swelsen, W.

AU - van der Pant, K. A.

AU - van der Weerd, N. C.

AU - ten Berge, I. J. M.

AU - Bemelman, F. J.

AU - Hoitsma, A.

AU - van der Boog, P. J. M.

AU - de Fijter, J. W.

AU - Betjes, M. G. H.

AU - Heidt, S.

AU - Roelen, D. L.

AU - Claas, F. H.

AU - Otten, H. G.

PY - 2018/9/1

Y1 - 2018/9/1

N2 - The presence of donor-specific anti-HLA antibodies (DSAs) is associated with increased risk of graft failure after kidney transplant. We hypothesized that DSAs against HLA class I, class II, or both classes indicate a different risk for graft loss between deceased and living donor transplant. In this study, we investigated the impact of pretransplant DSAs, by using single antigen bead assays, on long-term graft survival in 3237 deceased and 1487 living donor kidney transplants with a negative complement-dependent crossmatch. In living donor transplants, we found a limited effect on graft survival of DSAs against class I or II antigens after transplant. Class I and II DSAs combined resulted in decreased 10-year graft survival (84% to 75%). In contrast, after deceased donor transplant, patients with class I or class II DSAs had a 10-year graft survival of 59% and 60%, respectively, both significantly lower than the survival for patients without DSAs (76%). The combination of class I and II DSAs resulted in a 10-year survival of 54% in deceased donor transplants. In conclusion, class I and II DSAs are a clear risk factor for graft loss in deceased donor transplants, while in living donor transplants, class I and II DSAs seem to be associated with an increased risk for graft failure, but this could not be assessed due to their low prevalence. Via a retrospective multicenter study, the authors investigate the impact of pretransplant donor-specific HLA antibodies on long-term graft survival in deceased and living donor kidney transplantations.

AB - The presence of donor-specific anti-HLA antibodies (DSAs) is associated with increased risk of graft failure after kidney transplant. We hypothesized that DSAs against HLA class I, class II, or both classes indicate a different risk for graft loss between deceased and living donor transplant. In this study, we investigated the impact of pretransplant DSAs, by using single antigen bead assays, on long-term graft survival in 3237 deceased and 1487 living donor kidney transplants with a negative complement-dependent crossmatch. In living donor transplants, we found a limited effect on graft survival of DSAs against class I or II antigens after transplant. Class I and II DSAs combined resulted in decreased 10-year graft survival (84% to 75%). In contrast, after deceased donor transplant, patients with class I or class II DSAs had a 10-year graft survival of 59% and 60%, respectively, both significantly lower than the survival for patients without DSAs (76%). The combination of class I and II DSAs resulted in a 10-year survival of 54% in deceased donor transplants. In conclusion, class I and II DSAs are a clear risk factor for graft loss in deceased donor transplants, while in living donor transplants, class I and II DSAs seem to be associated with an increased risk for graft failure, but this could not be assessed due to their low prevalence. Via a retrospective multicenter study, the authors investigate the impact of pretransplant donor-specific HLA antibodies on long-term graft survival in deceased and living donor kidney transplantations.

KW - alloantibody

KW - clinical research

KW - practice

KW - graft survival

KW - kidney failure

KW - injury

KW - kidney transplantation

KW - nephrology

KW - living donor

KW - HIGHLY SENSITIZED PATIENTS

KW - HUMAN-LEUKOCYTE ANTIGEN

KW - LONG-TERM OUTCOMES

KW - KIDNEY-TRANSPLANTATION

KW - CROSS-MATCH

KW - RENAL-TRANSPLANTATION

KW - SINGLE-CENTER

KW - GRAFT LOSS

KW - REJECTION

KW - RISK

U2 - 10.1111/ajt.14709

DO - 10.1111/ajt.14709

M3 - Article

C2 - 29464832

SN - 1600-6135

VL - 18

SP - 2274

EP - 2284

JO - American Journal of Transplantation

JF - American Journal of Transplantation

IS - 9

ER -

Differential effects of donor-specific HLA antibodies in living versus deceased donor transplant

Abstract

Keywords

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