Correlations Between Donor-Specific Antibodies and Non-Adherence with Chronic Active Antibody-Mediated Rejection Phenotypes and Their Impact On Kidney Graft Survival.

Correlations Between Donor-Specific Antibodies and Non-Adherence with Chronic Active Antibody-Mediated Rejection Phenotypes and Their Impact On Kidney Graft Survival. Hum Immunol. 2018 Mar 22;: Authors: Malheiro J, Santos S, Tafulo S, Dias L, Salete Martins, Fonseca I, Almeida M, Pedroso S, Beirão I, Castro-Henriques A, Cabrita A Abstract Chronic-active antibody-mediated rejection (CAABMR) is associated with poor kidney graft survival and has no clear effective treatment. Forty-one cases of CAABMR were detected in indication graft biopsies and evaluated according to current Banff classification. We investigated the impact of concurrent donor-specific antibodies (DSA) and their characteristics, together with non-adherence regarding immunosuppression on CAABMR histopathological phenotypes and prognosis. Twenty-four (59%) patients had detectable DSA at biopsy, with 15 of them being considered non-adherent. Graft function at biopsy was similar in DSA (+) and (-) patients. DSA (+) patients had significantly higher tubulointerstitial inflammation (i and ti) and acute humoral (g+ptc+v+C4d) composite score than DSA (-). DSA (+)/non-adherent cases presented additionally with increased microvascular inflammation (ptc and v), besides having a distinctively lower ah score. C1q DSA strength was higher (P=0.046) in non-adherent patients and correlated closely with C4d score (P=0.002). Lower graft function and ah score, higher proteinuria and ci+c...
Source: Human Immunology - Category: Allergy & Immunology Authors: Tags: Hum Immunol Source Type: research