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Dynamic behaviour of donor specific antibodies in the early period following HLA incompatible kidney transplantation
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Phillpott, Mason, Daga, Sunil, Higgins, Rob, Lowe, David Philip, Krishnan, Nithya S., Zehnder, Daniel, Briggs, David and Khovanova, N. A. (2022) Dynamic behaviour of donor specific antibodies in the early period following HLA incompatible kidney transplantation. Transplant International, 35 . 10128. doi:10.3389/ti.2022.10128 ISSN 1432-2277.
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Official URL: https://doi.org/10.3389/ti.2022.10128
Abstract
In HLA-incompatible kidney transplantation, monitoring donor-specific antibodies (DSA) plays a crucial role in providing appropriate treatment and increases kidney survival times. This work aimed to determine if early post-transplant DSA dynamics inform graft outcome over and above other predictive factors. Eighty-eight cases were classified by unsupervised machine learning into five distinct DSA response groups: no response, fast modulation, slow modulation, rise to sustained and sustained. Fast modulation dynamics gave an 80% rate for early acute rejection, whereas the sustained group was associated with the lowest rejection rates (19%). In complete contrast, the five-year graft failure was lowest in the modulation groups (4–7%) and highest in the sustained groups (25–31%). Multivariable analysis showed that a higher pre-treatment DSA level, male gender and absence of early acute rejection were strongly associated with a sustained DSA response. The modulation group had excellent five-year outcomes despite higher rates of early rejection episodes. This work further develops an understanding of post-transplant DSA dynamics and their influence on graft survival following HLA-incompatible kidney transplantation.
Item Type: | Journal Article | ||||||||||||
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Subjects: | Q Science > QP Physiology Q Science > QR Microbiology R Medicine > RD Surgery |
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Divisions: | Faculty of Science, Engineering and Medicine > Engineering > Engineering Faculty of Science, Engineering and Medicine > Medicine > Warwick Medical School |
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SWORD Depositor: | Library Publications Router | ||||||||||||
Library of Congress Subject Headings (LCSH): | Kidneys -- Transplantation, Kidneys -- Transplantation -- Complications, Kidneys -- Transplantation -- Immunological aspects, Immunoglobulins | ||||||||||||
Journal or Publication Title: | Transplant International | ||||||||||||
Publisher: | Frontiers Media S.A. | ||||||||||||
ISSN: | 1432-2277 | ||||||||||||
Official Date: | 11 April 2022 | ||||||||||||
Dates: |
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Volume: | 35 | ||||||||||||
Article Number: | 10128 | ||||||||||||
DOI: | 10.3389/ti.2022.10128 | ||||||||||||
Status: | Peer Reviewed | ||||||||||||
Publication Status: | Published | ||||||||||||
Reuse Statement (publisher, data, author rights): | |||||||||||||
Access rights to Published version: | Open Access (Creative Commons) | ||||||||||||
Date of first compliant deposit: | 12 April 2022 | ||||||||||||
Date of first compliant Open Access: | 12 April 2022 | ||||||||||||
RIOXX Funder/Project Grant: |
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