The detrimental impact of persistent vs an isolated occurrence of de novo donor-specific antibodies on intermediate-term renal transplant outcomes

Research output: Contribution to journalArticle

Jennifer M Loucks-DeVos, Todd N Eagar, A Osama Gaber, Samir J. Patel, Larry D. Teeter, Edward A Graviss, Richard J Knight

Background: De novo donor-specific antibodies (dnDSA) after renal transplant are associated with acute rejection (AR) and graft loss, yet most recipients with dnDSA have stable function and no AR. We assessed whether the persistence of dnDSA increased the risk of a detrimental outcome. Methods: A single-center review of renal transplant recipients monitored for dnDSA at multiple time points post-transplant. An Isolated dnDSA was defined as one positive dnDSA and no additional positive tests, whereas ≥2 positive dnDSA was defined as persistent dnDSA. Results: Of 708 recipients, 22% developed dnDSA, of whom 64% had persistent dnDSA. At median follow-up of 35 (range 12-74) months, there were fewer episodes of AR in the isolated dnDSA vs the persistent dnDSA group (2% vs 22%; P<.001,) and fewer graft losses with isolated dnDSA vs persistent dnDSA (0% vs 10%; P=.03). Within the persistent dnDSA group, recipients with dnDSA ≥60% of time points, had more AR (32% vs 16%, P=.10) and more graft losses (21% vs 2%; P=.003) than those with dnDSA<60%. Conclusions: Persistence of dnDSA resulted in more AR and graft failure than a single positive value. Recipients with longer duration of dnDSA persistence had an additional increased risk of AR and graft failure.

Original languageEnglish (US)
JournalClinical Transplantation
Volume31
Issue number8
DOIs
StatePublished - Aug 2017

PMID: 28582797

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The detrimental impact of persistent vs an isolated occurrence of de novo donor-specific antibodies on intermediate-term renal transplant outcomes. / Loucks-DeVos, Jennifer M; Eagar, Todd N; Gaber, A Osama; Patel, Samir J.; Teeter, Larry D.; Graviss, Edward A; Knight, Richard J.

In: Clinical Transplantation, Vol. 31, No. 8, 08.2017.

Research output: Contribution to journalArticle

Harvard

Loucks-DeVos, JM, Eagar, TN, Gaber, AO, Patel, SJ, Teeter, LD, Graviss, EA & Knight, RJ 2017, 'The detrimental impact of persistent vs an isolated occurrence of de novo donor-specific antibodies on intermediate-term renal transplant outcomes' Clinical Transplantation, vol. 31, no. 8. https://doi.org/10.1111/ctr.13025

APA

Loucks-DeVos, J. M., Eagar, T. N., Gaber, A. O., Patel, S. J., Teeter, L. D., Graviss, E. A., & Knight, R. J. (2017). The detrimental impact of persistent vs an isolated occurrence of de novo donor-specific antibodies on intermediate-term renal transplant outcomes. Clinical Transplantation, 31(8). https://doi.org/10.1111/ctr.13025

Vancouver

Loucks-DeVos JM, Eagar TN, Gaber AO, Patel SJ, Teeter LD, Graviss EA et al. The detrimental impact of persistent vs an isolated occurrence of de novo donor-specific antibodies on intermediate-term renal transplant outcomes. Clinical Transplantation. 2017 Aug;31(8). https://doi.org/10.1111/ctr.13025

Author

Loucks-DeVos, Jennifer M ; Eagar, Todd N ; Gaber, A Osama ; Patel, Samir J. ; Teeter, Larry D. ; Graviss, Edward A ; Knight, Richard J. / The detrimental impact of persistent vs an isolated occurrence of de novo donor-specific antibodies on intermediate-term renal transplant outcomes. In: Clinical Transplantation. 2017 ; Vol. 31, No. 8.

BibTeX

@article{4410728df3a840a9bb70ee75757eff38,
title = "The detrimental impact of persistent vs an isolated occurrence of de novo donor-specific antibodies on intermediate-term renal transplant outcomes",
abstract = "Background: De novo donor-specific antibodies (dnDSA) after renal transplant are associated with acute rejection (AR) and graft loss, yet most recipients with dnDSA have stable function and no AR. We assessed whether the persistence of dnDSA increased the risk of a detrimental outcome. Methods: A single-center review of renal transplant recipients monitored for dnDSA at multiple time points post-transplant. An Isolated dnDSA was defined as one positive dnDSA and no additional positive tests, whereas ≥2 positive dnDSA was defined as persistent dnDSA. Results: Of 708 recipients, 22{\%} developed dnDSA, of whom 64{\%} had persistent dnDSA. At median follow-up of 35 (range 12-74) months, there were fewer episodes of AR in the isolated dnDSA vs the persistent dnDSA group (2{\%} vs 22{\%}; P<.001,) and fewer graft losses with isolated dnDSA vs persistent dnDSA (0{\%} vs 10{\%}; P=.03). Within the persistent dnDSA group, recipients with dnDSA ≥60{\%} of time points, had more AR (32{\%} vs 16{\%}, P=.10) and more graft losses (21{\%} vs 2{\%}; P=.003) than those with dnDSA<60{\%}. Conclusions: Persistence of dnDSA resulted in more AR and graft failure than a single positive value. Recipients with longer duration of dnDSA persistence had an additional increased risk of AR and graft failure.",
keywords = "HLA antibody, post-transplantation, Kidney clinical, Outcome<kidney clinical, Rejection<kidney clinical",
author = "Loucks-DeVos, {Jennifer M} and Eagar, {Todd N} and Gaber, {A Osama} and Patel, {Samir J.} and Teeter, {Larry D.} and Graviss, {Edward A} and Knight, {Richard J}",
note = "{\circledC} 2017 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.",
year = "2017",
month = "8",
doi = "10.1111/ctr.13025",
language = "English (US)",
volume = "31",
journal = "Clinical Transplantation",
issn = "0902-0063",
publisher = "Wiley",
number = "8",

}

RIS

TY - JOUR

T1 - The detrimental impact of persistent vs an isolated occurrence of de novo donor-specific antibodies on intermediate-term renal transplant outcomes

AU - Loucks-DeVos, Jennifer M

AU - Eagar, Todd N

AU - Gaber, A Osama

AU - Patel, Samir J.

AU - Teeter, Larry D.

AU - Graviss, Edward A

AU - Knight, Richard J

N1 - © 2017 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.

PY - 2017/8

Y1 - 2017/8

N2 - Background: De novo donor-specific antibodies (dnDSA) after renal transplant are associated with acute rejection (AR) and graft loss, yet most recipients with dnDSA have stable function and no AR. We assessed whether the persistence of dnDSA increased the risk of a detrimental outcome. Methods: A single-center review of renal transplant recipients monitored for dnDSA at multiple time points post-transplant. An Isolated dnDSA was defined as one positive dnDSA and no additional positive tests, whereas ≥2 positive dnDSA was defined as persistent dnDSA. Results: Of 708 recipients, 22% developed dnDSA, of whom 64% had persistent dnDSA. At median follow-up of 35 (range 12-74) months, there were fewer episodes of AR in the isolated dnDSA vs the persistent dnDSA group (2% vs 22%; P<.001,) and fewer graft losses with isolated dnDSA vs persistent dnDSA (0% vs 10%; P=.03). Within the persistent dnDSA group, recipients with dnDSA ≥60% of time points, had more AR (32% vs 16%, P=.10) and more graft losses (21% vs 2%; P=.003) than those with dnDSA<60%. Conclusions: Persistence of dnDSA resulted in more AR and graft failure than a single positive value. Recipients with longer duration of dnDSA persistence had an additional increased risk of AR and graft failure.

AB - Background: De novo donor-specific antibodies (dnDSA) after renal transplant are associated with acute rejection (AR) and graft loss, yet most recipients with dnDSA have stable function and no AR. We assessed whether the persistence of dnDSA increased the risk of a detrimental outcome. Methods: A single-center review of renal transplant recipients monitored for dnDSA at multiple time points post-transplant. An Isolated dnDSA was defined as one positive dnDSA and no additional positive tests, whereas ≥2 positive dnDSA was defined as persistent dnDSA. Results: Of 708 recipients, 22% developed dnDSA, of whom 64% had persistent dnDSA. At median follow-up of 35 (range 12-74) months, there were fewer episodes of AR in the isolated dnDSA vs the persistent dnDSA group (2% vs 22%; P<.001,) and fewer graft losses with isolated dnDSA vs persistent dnDSA (0% vs 10%; P=.03). Within the persistent dnDSA group, recipients with dnDSA ≥60% of time points, had more AR (32% vs 16%, P=.10) and more graft losses (21% vs 2%; P=.003) than those with dnDSA<60%. Conclusions: Persistence of dnDSA resulted in more AR and graft failure than a single positive value. Recipients with longer duration of dnDSA persistence had an additional increased risk of AR and graft failure.

KW - HLA antibody, post-transplantation

KW - Kidney clinical

KW - Outcome<kidney clinical

KW - Rejection<kidney clinical

UR - http://www.scopus.com/inward/record.url?scp=85021846633&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=85021846633&partnerID=8YFLogxK

U2 - 10.1111/ctr.13025

DO - 10.1111/ctr.13025

M3 - Article

VL - 31

JO - Clinical Transplantation

T2 - Clinical Transplantation

JF - Clinical Transplantation

SN - 0902-0063

IS - 8

ER -

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