Donation type and the effect of pre-transplant donor specific antibodies - Data from the Swiss Transplant Cohort Study.
ABMR
DBD
DCD
donor specific antibodies
graft loss
kidney transplantation
living donation
virtual cross-match
Journal
Frontiers in immunology
ISSN: 1664-3224
Titre abrégé: Front Immunol
Pays: Switzerland
ID NLM: 101560960
Informations de publication
Date de publication:
2023
2023
Historique:
received:
21
11
2022
accepted:
30
01
2023
entrez:
6
3
2023
pubmed:
7
3
2023
medline:
8
3
2023
Statut:
epublish
Résumé
The type of donation may affect how susceptible a donor kidney is to injury from pre-existing alloimmunity. Many centers are, therefore, reluctant to perform donor specific antibody (DSA) positive transplantations in the setting of donation after circulatory death (DCD). There are, however, no large studies comparing the impact of pre-transplant DSA stratified on donation type in a cohort with a complete virtual cross-match and long-term follow-up of transplant outcome. We investigated the effect of pre-transplant DSA on the risk of rejection, graft loss, and the rate of eGFR decline in 1282 donation after brain death (DBD) transplants and compared it to 130 (DCD) and 803 living donor (LD) transplants. There was a significant worse outcome associated with pre-transplant DSA in all of the studied donation types. DSA directed against Class II HLA antigens as well as a high cumulative mean fluorescent intensity (MFI) of the detected DSA showed the strongest association with worse transplant outcome. We could not detect a significant additive negative effect of DSA in DCD transplantations in our cohort. Conversely, DSA positive DCD transplants appeared to have a slightly better outcome, possibly in part due to the lower mean fluorescent intensity (MFI) of the pre-transplant DSA. Indeed when DCD transplants were compared to DBD transplants with similar MFI (<6.5k), graft survival was not significantly different. Our results suggest that the negative impact of pre-transplant DSA on graft outcome could be similar between all donation types. This suggests that immunological risk assessment could be performed in a similar way regardless of the type of donor kidney transplantation.
Identifiants
pubmed: 36875145
doi: 10.3389/fimmu.2023.1104371
pmc: PMC9974644
doi:
Substances chimiques
Antibodies
0
Types de publication
Journal Article
Research Support, Non-U.S. Gov't
Langues
eng
Sous-ensembles de citation
IM
Pagination
1104371Investigateurs
Patrizia Amico
(P)
Andres Axel
(A)
John David Aubert
(JD)
Vanessa Banz
(V)
Beckmann Sonja
(B)
Guido Beldi
(G)
Christoph Berger
(C)
Ekaterine Berishvili
(E)
Isabelle Binet
(I)
Pierre-Yves Bochud
(PY)
Sanda Branca
(S)
Heiner Bucher
(H)
Thierry Carrel
(T)
Emmanuelle Catana
(E)
Yves Chalandon
(Y)
Sabina De Geest
(S)
Olivier De Rougemont
(O)
Michael Dickenmann
(M)
Joëlle Lynn Dreifuss
(JL)
Michel Duchosal
(M)
Thomas Fehr
(T)
Sylvie Ferrari-Lacraz
(S)
Nicola Franscini
(N)
Christian Garzoni
(C)
Paola Gasche Soccal
(PG)
Christophe Gaudet
(C)
Déla Golshayan
(D)
Nicolas Goossens
(N)
Karine Hadaya
(K)
Jörg Halter
(J)
Dominik Heim
(D)
Christoph Hess
(C)
Sven Hillinger
(S)
Hans Hirsch
(H)
Patricia Hirt
(P)
Günther Hofbauer
(G)
Uyen Huynh-Do
(U)
Franz Immer
(F)
Michael Koller
(M)
Mirjam Laager
(M)
Bettina Laesser
(B)
Roger Lehmann
(R)
Alexander Leichtle
(A)
Christian Lovis
(C)
Oriol Manuel
(O)
Hans-Peter Marti
(HP)
Pierre Yves Martin
(PY)
Michele Martinelli
(M)
Valérie McLin
(V)
Katell Mellac
(K)
Aurelia Mercay
(A)
Karin Mettler
(K)
Nicolas Mueller
(N)
Antonia Müller
(A)
Thomas Müller
(T)
Ulrike Müller-Arndt
(U)
Beat Müllhaupt
(B)
Mirjam Nägeli
(M)
Graziano Oldani
(G)
Manuel Pascual
(M)
Klara Posfay-Barbe
(K)
Juliane Rick
(J)
Anne Rosselet
(A)
Simona Rossi
(S)
Silvia Rothlin
(S)
Frank Ruschitzka
(F)
Urs Schanz
(U)
Stefan Schaub
(S)
Aurelia Schnyder
(A)
Macé Schuurmans
(M)
Thierry Sengstag
(T)
Federico Simonetta
(F)
Katharina Staufer
(K)
Susanne Stampf
(S)
Jürg Steiger
(J)
Guido Stirniman
(G)
Ueli Stürzinger
(U)
Christian Van Delden
(C)
Jean-Pierre Venetz
(JP)
Jean Villard
(J)
Julien Vionnet
(J)
Madeleine Wick
(M)
Markus Wilhlem
(M)
Patrick Yerly
(P)
Informations de copyright
Copyright © 2023 de Rougemont, Deng, Frischknecht, Wehmeier, Villard, Ferrari-Lacraz, Golshayan, Gannagé, Binet, Wirthmueller, Sidler, Schachtner, Schaub, Nilsson and the Swiss Transplant Cohort Study.
Déclaration de conflit d'intérêts
The authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest.
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