The clinicopathological relevance of pretransplant anti-angiotensin II type 1 receptor antibodies in renal transplantation
- Authors
- Lee, Juhan; Huh, Kyu Ha; Park, Yongjung; Park, Borae G.; Yang, Jaeseok; Jeong, Jong Cheol; Lee, Joongyup; Park, Jae Berm; Cho, Jang-Hee; Lee, Sik; Ro, Han; Han, Seung-Yeup; Kim, Myoung Soo; Kim, Yu Seun; Kim, Sung Joo; Kim, Chan-Duck; Chung, Wookyung; Park, Sung-Bae; Ahn, Curie
- Issue Date
- Jul-2017
- Publisher
- OXFORD UNIV PRESS
- Keywords
- acute rejection; angiotensin II type 1 receptor antibody; antibody-mediated injury; pretransplant; renal transplantation
- Citation
- NEPHROLOGY DIALYSIS TRANSPLANTATION, v.32, no.7, pp.1244 - 1250
- Journal Title
- NEPHROLOGY DIALYSIS TRANSPLANTATION
- Volume
- 32
- Number
- 7
- Start Page
- 1244
- End Page
- 1250
- URI
- https://scholarworks.bwise.kr/gachon/handle/2020.sw.gachon/5946
- DOI
- 10.1093/ndt/gfv375
- ISSN
- 0931-0509
- Abstract
- Background: Anti-angiotensin II type 1 receptor antibodies (AT1R-Abs) have been suggested as a risk factor for graft failure and acute rejection (AR). However, the prevalence and clinical significance of pretransplant AT1R-Abs have seldom been evaluated in Asia. Methods: In this multicenter, observational cohort study, we tested the AT1R-Abs in pretransplant serum samples obtained from 166 kidney transplant recipients. Statistical analysis was used to set a threshold AT1R-Abs level at 9.05 U/mL. Results: Pretransplant AT1R-Abs were detected in 98/166 (59.0%) of the analyzed recipients. No graft loss or patient death was reported during the study period. AT1R-Abs (I) patients had a significantly higher incidence of biopsy-proven AR than AT1R-Abs ( ) patients (27.6 versus 10.3%, P = 0.007). Recipients with pretransplant AT1R-Abs had a 3.2-fold higher risk of AR within a year of transplantation (P = 0.006). Five study subjects developed microcirculation inflammation (score >= 2). Four of them were presensitized to AT1R-Abs. In particular, three patients had a high titer of anti-AT1R-Abs (>22.7 U/mL). Conclusions: Pretransplant AT1R-Abs is an independent risk factor for AR, especially acute cellular rejection, and is possibly associated with the risk of antibody-mediated injury. Pretransplant assessment of AT1R-Abs may be useful for stratifying immunologic risks.
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