Impact of de novo donor-specific HLA antibodies detected by Luminex solid-phase assay after transplantation in a group of 88 consecutive living-donor renal transplantations.
De novo donor-specific HLA antibodies (DSA) after renal transplantation are known to be correlated with poor graft outcome and the development of acute and chronic rejection. Currently, data for the influence of de novo DSA in patient cohorts including only living-donor renal transplantations (LDRT) are limited. A consecutive cohort of 88 LDRT was tested for the occurrence of de novo DSA by utilizing the highly sensitive Luminex solid-phase assay for antibody detection. Data were analyzed for risk factors for de novo DSA development and correlated with acute rejection (AR) and graft function. Patients with de novo DSA [31 (35%)] showed a trend for inferior graft function [mean creatinine change (mg/dL/year) after the first year: 0.15 DSA (+) vs. 0.02 DSA (-) (P = 0.10)] and a higher rate of AR episodes, especially in case of de novo DSA of both class I and II [6 (55%), (P = 0.05)]. Antibody-mediated rejection (AMR) appeared in five patients and was significantly correlated with de novo DSA (P = 0.05). Monitoring for de novo DSA after LDRT may help to identify patients at risk of declining renal function. Especially patients with simultaneous presence of de novo DSA class I and class II are at a high risk to suffer AR episodes.
['Dieplinger|Georg|G|', 'Ditt|Vanessa|V|', 'Arns|Wolfgang|W|', 'Huppertz|Andrea|A|', 'Kisner|Tuelay|T|', 'Hellmich|Martin|M|', 'Bauerfeind|Ursula|U|', 'Stippel|Dirk L|DL|']
D000293:Adolescent D000328:Adult D002648:Child D003404:Creatinine D005260:Female D006084:Graft Rejection D015395:Histocompatibility Antigens Class I D000949:Histocompatibility Antigens Class II D006801:Humans D007518:Isoantibodies D016030:Kidney Transplantation D019520:Living Donors D008297:Male D008875:Middle Aged D012307:Risk Factors D016896:Treatment Outcome
Luminex solid-phase assay living-donor renal transplantation antibody-mediated rejection AMR de novo 
DSA donor-specific antibodies