LABOUX, Timothee; LENAIN, Remi; VISENTIN, Jonathan; FLAHAUT, Gauthier; CHAMLEY, Paul; PROVÔT, François; TOP, Isabelle; KERLEAU, Clarisse; LABALETTE, Myriam; CHOUKROUN, Gabriel; COUZI, Lionel; BLANCHO, Gilles; HAZZAN, Marc; MAANAOUI, Mehdi

doi:10.3389/ti.2023.11416

VISENTIN, Jonathan
Immunology from Concept and Experiments to Translation = Immunologie Conceptuelle, Expérimentale et Translationnelle [ImmunoConcept]

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Transplant International. 2023-11, vol. 36, p. 11416

Résumé en anglais

Given the risk of rejection, the presence of preformed donor specific antibodies (DSA) contraindicates transplantation in most allocation systems. However, HLA-Cw and -DP DSA escape this censorship. We performed a multicentric observational study, in which the objective was to determinate risk factors of acute antibody-mediated rejection (aABMR) in recipients transplanted with preformed isolated Cw- or DP-DSA. Between 2010 and 2019, 183 patients were transplanted with a preformed isolated Cw- or DP-DSA (92 Cw-DSA; 91 DP-DSA). At 2 years, the incidence of aABMR was 12% in the Cw-DSA group, versus 28% in the DP-DSA group. Using multivariable Cox regression model, the presence of a preformed DP-DSA was associated with an increased risk of aABMR (HR = 2.32 [1.21–4.45 (p = 0.001)]) compared with Cw-DSA. We also observed a significant association between the DSA’s MFI on the day of transplant and the risk of aABMR (HR = 1.09 [1.08–1.18], p = 0.032), whatever the DSA was. Interaction term analysis found an increased risk of aABMR in the DP-DSA group compared with Cw-DSA, but only for MFI below 3,000. These results may plead for taking these antibodies into account in the allocation algorithms, in the same way as other DSA. Copyright © 2023 Laboux, Lenain, Visentin, Flahaut, Chamley, Provôt, Top, Kerleau, Labalette, Choukroun, Couzi, Blancho, Hazzan and Maanaoui.< Réduire

Mots clés en anglais

Donor-specific antibodies

kidney transplant

acute antibody-mediated rejection

HLA-Cw

HLA-DP

URI

https://oskar-bordeaux.fr/handle/20.500.12278/199823

DOI

http://dx.doi.org/10.3389/ti.2023.11416

Unités de recherche

ImmunoConcEpT - UMR 5164

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Impact of Preformed Donor-Specific Anti-HLA-Cw and Anti-HLA-DP Antibodies on Acute Antibody-Mediated Rejection in Kidney Transplantation

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