Sánchez Zapardiel, Elena Mancebo Sierra, Esther Serrano Hernández, Antonio Castro Panete, María José Utrero Rico, Alberto Andrés Belmonte, Amado Morales Cerdán, José María Paz Artal, Estela
Isolated De Novo Antiendothelial Cell Antibodies and Kidney Transplant Rejection. [artículo] - American journal of kidney diseases : the official journal of the National Kidney Foundation, 2016 - 68(6):933-43.
Formato Vancouver:
Sánchez Zapardiel E, Mancebo E, Díaz Ordoñez M, de Jorge Huerta L, Ruiz Martínez L, Serrano A et al. Isolated De Novo Antiendothelial Cell Antibodies and Kidney Transplant Rejection. Am J Kidney Dis. 2016 Dec;68(6):933-43.
PMID: 27599627
Contiene 34 referencias
Background: Studies analyzing the role of antiendothelial cell antibodies (AECAs) in large series of kidney transplant recipients are scarce, and HLA, MHC (major histocompatibility complex) class I-related chain A (MICA), and angiotensin II type 1 receptor have not been formally excluded as targets.
Study design: Retrospective study of a cohort of kidney transplant recipients.
Setting & participants: 324 kidney transplant recipients who were negative for anti-HLA, anti-MICA, and anti-angiotensin II type 1 receptor antibodies were tested for AECAs in pre- and posttransplantation serum samples.
Predictors: AECA-positive (preformed [pre+/post+] vs de novo [pre-/post+]) versus AECA-negative (pre-/post-) before or after transplantation.
Outcomes: Patient mortality, transplant loss, and acute rejection events.
Results: 66 (20%) patients were AECA positive (39 [12%] preformed, 27 [8%] de novo) and 258 (80%) were AECA negative. During a follow-up of 10 years, 7 (18%) AECA pre+/post+ patients had rejections compared with 14 (52%) AECA pre-/post+ and 57 (22%) AECA pre-/post- recipients (OR, 3.80; P=0.001). AECA pre-/post+ status emerged as an independent risk factor for transplant rejection compared to the AECA pre-/post- group (OR, 5.17; P<0.001). However, AECA pre+/post+ and AECA pre-/post+ patients did not show higher risk for either patient death (ORs of 1.49 [P=0.7] and 1.06 [P=0.9], respectively) or transplant loss (ORs of 1.22 and 0.86, respectively; P for both = 0.8) compared to the AECA pre-/post- population.
Limitations: Retrospective study. Posttransplantation sera were collected before or after rejection, entailing a nearly cross-sectional relationship between the exposure and outcome. Lack of identification of precise antigens for AECAs.
Conclusions: De novo AECAs may be associated with rejection. These antibodies might serve as biomarkers of endothelium damage in kidney transplant recipients.
Isolated De Novo Antiendothelial Cell Antibodies and Kidney Transplant Rejection. [artículo] - American journal of kidney diseases : the official journal of the National Kidney Foundation, 2016 - 68(6):933-43.
Formato Vancouver:
Sánchez Zapardiel E, Mancebo E, Díaz Ordoñez M, de Jorge Huerta L, Ruiz Martínez L, Serrano A et al. Isolated De Novo Antiendothelial Cell Antibodies and Kidney Transplant Rejection. Am J Kidney Dis. 2016 Dec;68(6):933-43.
PMID: 27599627
Contiene 34 referencias
Background: Studies analyzing the role of antiendothelial cell antibodies (AECAs) in large series of kidney transplant recipients are scarce, and HLA, MHC (major histocompatibility complex) class I-related chain A (MICA), and angiotensin II type 1 receptor have not been formally excluded as targets.
Study design: Retrospective study of a cohort of kidney transplant recipients.
Setting & participants: 324 kidney transplant recipients who were negative for anti-HLA, anti-MICA, and anti-angiotensin II type 1 receptor antibodies were tested for AECAs in pre- and posttransplantation serum samples.
Predictors: AECA-positive (preformed [pre+/post+] vs de novo [pre-/post+]) versus AECA-negative (pre-/post-) before or after transplantation.
Outcomes: Patient mortality, transplant loss, and acute rejection events.
Results: 66 (20%) patients were AECA positive (39 [12%] preformed, 27 [8%] de novo) and 258 (80%) were AECA negative. During a follow-up of 10 years, 7 (18%) AECA pre+/post+ patients had rejections compared with 14 (52%) AECA pre-/post+ and 57 (22%) AECA pre-/post- recipients (OR, 3.80; P=0.001). AECA pre-/post+ status emerged as an independent risk factor for transplant rejection compared to the AECA pre-/post- group (OR, 5.17; P<0.001). However, AECA pre+/post+ and AECA pre-/post+ patients did not show higher risk for either patient death (ORs of 1.49 [P=0.7] and 1.06 [P=0.9], respectively) or transplant loss (ORs of 1.22 and 0.86, respectively; P for both = 0.8) compared to the AECA pre-/post- population.
Limitations: Retrospective study. Posttransplantation sera were collected before or after rejection, entailing a nearly cross-sectional relationship between the exposure and outcome. Lack of identification of precise antigens for AECAs.
Conclusions: De novo AECAs may be associated with rejection. These antibodies might serve as biomarkers of endothelium damage in kidney transplant recipients.
