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Transplantation

Donor-specific HLA antibodies and renal allograft failure

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A new meta-analysis shows a strong association between low levels of preformed donor-specific HLA antibodies (DSAs) detected using sensitive solid-phase assays and an increased risk of renal allograft failure. These findings have important implications for stratifying patients with DSAs for organ allocation and for the use of alloantigen desensitization therapies.

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References

  1. Mohan, S. et al. Donor-specific antibodies adversely affect kidney allograft outcomes. J. Am. Soc. Nephrol. 12, 2061–2071 (2012).

    Article  Google Scholar 

  2. Einecke, G. et al. Antibody-mediated microcirculation injury is the major cause of late kidney transplant failure. Am. J. Transplant. 9, 2520–2531 (2009).

    Article  CAS  Google Scholar 

  3. Gaston, R. S. et al. Evidence for antibody-mediated injury as a major determinant of late kidney allograft failure. Transplantation 90, 68–74 (2010).

    Article  CAS  Google Scholar 

  4. Sellares, J. et al. Understanding the causes of kidney transplant failure: the dominant role of antibody-mediated rejection and nonadherence. Am. J. Transplant. 12, 388–399 (2012).

    Article  CAS  Google Scholar 

  5. Colvin, R. B. Antibody-mediated renal allograft rejection: diagnosis and pathogenesis. J. Am. Soc. Nephrol. 18, 1046–1056 (2007).

    Article  CAS  Google Scholar 

  6. Vo, A. A. et al. Rituximab and intravenous immune globulin for desensitization during renal transplantation. N. Engl. J. Med. 359, 242–251 (2008).

    Article  CAS  Google Scholar 

  7. Lefaucheur, C. et al. Preexisting donor-specific HLA antibodies predict outcome in kidney transplantation. J. Am. Soc. Nephrol. 21, 1398–1406 (2010).

    Article  Google Scholar 

  8. Lefaucheur, C. et al. Antibody-mediated vascular rejection of kidney allografts: a population-based study. Lancet 381, 313–319 (2013).

    Article  CAS  Google Scholar 

  9. Lai, C. H. et al. Antibody testing strategies for deceased donor kidney transplantation after immunomodulatory therapy. Transplantation 92, 48–53 (2011).

    Article  CAS  Google Scholar 

  10. Chin, C. et al. Clinical usefulness of a novel C1q assay to detect immunoglobulin G antibodies capable of fixing complement in sensitized pediatric heart transplant patients. J. Heart Lung Transplant. 30, 158–163 (2011).

    Article  Google Scholar 

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Acknowledgements

We would like to acknowledge the support of the Paris Cardiovascular Research Centre University Paris, Descartes and the Transplant Immunotherapy Program and HLA Laboratory at Cedars-Sinai Medical Center.

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Correspondence to Stanley C. Jordan.

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The authors declare no competing financial interests.

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Loupy, A., Jordan, S. Donor-specific HLA antibodies and renal allograft failure. Nat Rev Nephrol 9, 130–131 (2013). https://doi.org/10.1038/nrneph.2013.18

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  • DOI: https://doi.org/10.1038/nrneph.2013.18

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