Impact of de novo donor-specific anti-HLA antibodies on grafts outcomes in simultaneous XXXX .

@entity1 @entity8 @entity177
UNASSIGNED: De novo donor-specific antibodies (dDSA) relevance in simultaneous @entity8 (SPK) transplantation has been scarcely investigated. We analyzed dDSA relationship with grafts outcomes in a long-term follow-up SPK-transplanted cohort. In 150 @entity1 that received SPK transplant between 2000 and 2013, post-transplant anti-human leukocyte antigen (HLA) antibodies were screened and identified using Luminex-based assays in sera collected at 3, 6, and 12 months, then yearly. dDSA were detected in 22 (14.7%) @entity1 at a median 3.1 years after transplant. Pretransplant anti-HLA sensitization (OR = 4.64), full HLA-DR mismatch (OR = 4.38), and previous acute cellular rejection (OR = 9.45) were significant risk factors for dDSA. dDSA were significantly associated with kidney (in association with acute rejection) and @entity177 . In dDSA+ @entity1 , those with at least one graft failure presented more frequently dDSA against class II or I + II (P = 0.011) and locusDQ (P = 0.043) and had a higher median dDSA number (P = 0.014) and strength (P = 0.030). Median time between dDSA emergence and @entity177 was 5 and 12 months, respectively. Emergence of dDSA increased the risk of grafts failure in SPK-transplanted @entity1 . Full HLA-DR mismatch was associated with dDSA emergence. dDSA characteristics might help identify @entity1 at a higher risk of graft failure.
