C3d-Positive Preformed DSAs Tend to Persist and Result in a Higher Risk of AMR after Kidney Transplantsopen access
- Authors
- Choi, Sooin; Lee, Kyo Won; Park, Jae Berm; Kim, Kyunga; Jang, Hye-Ryeon; Huh, Wooseong; Kang, Eun Suk
- Issue Date
- Feb-2020
- Publisher
- MDPI AG
- Keywords
- kidney transplant (KT); donor-specific antibodies (DSA); C3d-binding assay; antibody-mediated rejection (AMR)
- Citation
- Journal of Clinical Medicine, v.9, no.2
- Journal Title
- Journal of Clinical Medicine
- Volume
- 9
- Number
- 2
- URI
- https://scholarworks.bwise.kr/sch/handle/2021.sw.sch/19586
- DOI
- 10.3390/jcm9020375
- ISSN
- 2077-0383
- Abstract
- C3d-binding assays have been introduced as methods for the prediction of the presence of complement-binding functional antibodies; however, the prognostic value of C3d-positive preformed donor-specific antibodies (pDSAs) has not been fully evaluated. In this study, we performed a retrospective investigation of the association of pDSAs and their C3d-binding capacity with one-year clinical outcomes. pDSAs were defined as donor-specific antibodies (DSAs) that were produced before kidney transplants (KTs) (pre-pDSAs) or within the first four weeks after KTs, owing to rebound immune response (post-pDSAs). Of 455 adult KT recipients, pre-pDSAs and post-pDSAs were found in 56 (12.3%) and 56 (12.3%) recipients, respectively, and C3d-positive post-pDSAs were found in 13 recipients (2.9%) in total. Approximately half of the C3d-negative pre-pDSAs (37/73, 50.7%) disappeared after transplantation; however, all C3d-positive pre-pDSAs (8/8, 100%) persisted after transplantation despite desensitization (p = 0.008). C3d-positive pDSAs were significantly associated with a higher incidence and risk of AMR (p < 0.001, OR 94.467-188.934). Identification of the C3d-binding activity of pDSAs before and early after KT is important for predicting the persistence of pDSAs and the risk of AMR induced by the presence of pDSAs.
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Collections - College of Medicine > Department of Clinical Pathology > 1. Journal Articles
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