دورية أكاديمية
Impact of ABO incompatibility and early antibody-mediated rejection on chronic antibody-mediated rejection in kidney transplant patients.
| العنوان: | Impact of ABO incompatibility and early antibody-mediated rejection on chronic antibody-mediated rejection in kidney transplant patients. |
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| المؤلفون: | Heo GY; Department of Internal Medicine, Yonsei University College of Medicine, Seoul, Republic of Korea., Jang Y; Department of Internal Medicine, Seoul National University College of Medicine, Seoul, Republic of Korea., Choi H; Department of Pathology, Yonsei University College of Medicine, Seoul, Republic of Korea., Kim YC; Department of Internal Medicine, Seoul National University College of Medicine, Seoul, Republic of Korea., Han SS; Department of Internal Medicine, Seoul National University College of Medicine, Seoul, Republic of Korea., Kim HW; Department of Internal Medicine, Yonsei University College of Medicine, Seoul, Republic of Korea., Lee J; Department of Surgery, Yonsei University College of Medicine, Seoul, Republic of Korea., Huh KH; Department of Surgery, Yonsei University College of Medicine, Seoul, Republic of Korea., Kim BS; Department of Internal Medicine, Yonsei University College of Medicine, Seoul, Republic of Korea., Yang J; Department of Internal Medicine, Yonsei University College of Medicine, Seoul, Republic of Korea. jcyjs@yuhs.ac. |
| المصدر: | Journal of nephrology [J Nephrol] 2023 Dec; Vol. 36 (9), pp. 2571-2580. Date of Electronic Publication: 2023 Apr 27. |
| نوع المنشور: | Journal Article |
| اللغة: | English |
| بيانات الدورية: | Publisher: Springer Country of Publication: Italy NLM ID: 9012268 Publication Model: Print-Electronic Cited Medium: Internet ISSN: 1724-6059 (Electronic) Linking ISSN: 11218428 NLM ISO Abbreviation: J Nephrol Subsets: MEDLINE |
| أسماء مطبوعة: | Publication: 2014- : Heidelberg : Springer Original Publication: Rome : Acta Medica, |
| مواضيع طبية MeSH: | Kidney Transplantation*/adverse effects, Humans ; Immunosuppressive Agents ; Retrospective Studies ; Graft Rejection/diagnosis ; Graft Rejection/prevention & control ; Blood Group Incompatibility ; Living Donors ; Graft Survival ; ABO Blood-Group System |
| مستخلص: | Introduction: Early antibody-mediated rejection has been reported to increase chronic antibody-mediated rejection and decrease graft survival in kidney transplantation. However, the impact of early antibody-mediated rejection in ABO-incompatible kidney transplantation remains unclear. Methods: We retrospectively analyzed living-donor kidney transplantation patients from two Korean centers. Patients were categorized based on ABO compatibility and early antibody-mediated rejection within 1 year. The primary outcome was chronic antibody-mediated rejection. The secondary outcomes were production of de novo donor-specific antibody and composite kidney outcome, defined as graft loss or a decline in estimated glomerular filtration rate to below 30 mL/min/1.73 m 2 . Results: A total of 1639 patients were analyzed, including 1292 patients who underwent ABO-compatible kidney transplantation and 347 patients who underwent ABO-incompatible kidney transplantation. ABO-incompatible kidney transplantation had a lower risk of de novo donor-specific antibody production (hazard ratio [HR] 0.68, 95% confidence interval [CI] 0.48-0.95) and chronic antibody-mediated rejection (HR 0.33, 95% CI 0.12-0.92) with a comparable risk of the composite kidney outcome (HR 1.06, 95% CI 0.71-1.59) compared to ABO-compatible kidney transplantation. When outcomes of ABO-incompatible kidney transplantation were analyzed according to early antibody-mediated rejection, ABO-incompatible kidney transplantation without antibody-mediated rejection had a lower risk of de novo donor-specific antibody production (HR 0.60, 95% CI 0.41-0.88) and chronic antibody-mediated rejection (HR 0.28, 95% CI 0.09-0.91) than ABO-compatible kidney transplantation without antibody-mediated rejection. However, ABO-incompatible kidney transplantation with antibody-mediated rejection showed a higher risk of de novo donor-specific antibody production and similar risk of chronic antibody-mediated rejection compared to ABO-compatible kidney transplantation without antibody-mediated rejection. Conclusions: ABO-incompatible kidney transplantation showed a lower risk of de novo donor-specific antibody production and chronic antibody-mediated rejection compared to ABO-compatible kidney transplantation; however, early antibody-mediated rejection abrogated these beneficial effects of ABO-incompatible kidney transplantation. (© 2023. The Author(s) under exclusive licence to Italian Society of Nephrology.) |
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| فهرسة مساهمة: | Keywords: ABO incompatibility; De novo donor-specific antibody; Kidney outcome; Kidney transplantation; Rejection |
| المشرفين على المادة: | 0 (Immunosuppressive Agents) 0 (ABO Blood-Group System) |
| تواريخ الأحداث: | Date Created: 20230427 Date Completed: 20231211 Latest Revision: 20240116 |
| رمز التحديث: | 20240116 |
| DOI: | 10.1007/s40620-023-01643-7 |
| PMID: | 37106218 |
| قاعدة البيانات: | MEDLINE |
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Full Text Finder | تدمد: | 1724-6059 |
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| DOI: | 10.1007/s40620-023-01643-7 |