Complement Binding Anti-HLA Antibodies and the Survival of Kidney Transplantation
Metadatos
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MDPI
Materia
AMR Antibody-mediated rejection DSA Donor specific antibodies DnDSA De novo donor-specific antibodies Complement-fixing DSA Renal transplant Kidney graft
Date
2023-03-17Referencia bibliográfica
Muñoz-Herrera, C.M.; Gutiérrez-Bautista, J.F.; López-Nevot, M.Á. Complement Binding Anti-HLA Antibodies and the Survival of Kidney Transplantation. J. Clin. Med. 2023, 12, 2335. [https://doi.org/10.3390/jcm12062335]
Résumé
Background: Antibody-mediated rejection (AMR) is one of the most important challenges in
the context of renal transplantation, because the binding of de novo donor-specific antibodies (dnDSA)
to the kidney graft triggers the activation of the complement, which in turn leads to loss of transplant.
In this context, the objective of this study was to evaluate the association between complement-fixing
dnDSA antibodies and graft loss as well as the possible association between non-complement-fixing
antibodies and transplanted organ survival in kidney transplant recipients. Methods: Our study
included a cohort of 245 transplant patients over a 5-year period at Virgen de las Nieves University
Hospital (HUVN) in Granada, Spain. Results: dnDSA was observed in 26 patients. Of these patients,
17 had non-complement-fixing dnDSA and 9 had complement-fixing dnDSA. Conclusions: Our study
demonstrated a significant association between the frequency of rejection and renal graft loss and
the presence of C1q-binding dnDSA. Our results show the importance of the individualization of
dnDSA, classifying them according to their ability to activate the complement, and suggest that the
detection of complement-binding capacity by dnDSA could be used as a prognostic marker to predict
AMR outcome and graft survival in kidney transplant patients who develop dnDSA.