Donor-specific antibodies adversely affect kidney allograft outcomes

Sumit Mohan, Amudha Palanisamy, Demetra Tsapepas, Bekir Tanriover, R. John Crew, Geoffrey Dube, Lloyd E. Ratner, David J. Cohen, Jai Radhakrishnan

Research output: Contribution to journalArticle

149 Citations (Scopus)

Abstract

The effect of low titers of donor-specific antibodies (DSAs) detected only by sensitive solid-phase assays (SPAs) on renal transplant outcomes is unclear. We report the results of a systematic review and meta-analysis of rejection rates and graft outcomes for renal transplant recipients with such preformed DSAs, defined by positive results on SPA but negative complement-dependent cytotoxicity and flow cytometry crossmatch results. Our search identified seven retrospective cohort studies comprising a total of 1119 patients, including 145 with isolated DSA-SPA. Together, these studies suggest that the presence of DSA-SPA, despite a negative flow cytometry crossmatch result, nearly doubles the risk for antibody-mediated rejection (relative risk [RR], 1.98; 95% confidence interval [CI], 1.36-2.89; P<0.001) and increases the risk for graft failure by 76% (RR, 1.76; 95% CI, 1.13-2.74; P=0.01). These results suggest that donor selection should consider the presence of antibodies in the recipient, identified by the SPA, even in the presence of a negative flow cytometry crossmatch result.

Original languageEnglish (US)
Pages (from-to)2061-2071
Number of pages11
JournalJournal of the American Society of Nephrology
Volume23
Issue number12
DOIs
StatePublished - 2012

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Allografts
Tissue Donors
Kidney
Antibodies
Flow Cytometry
Confidence Intervals
Transplants
Donor Selection
Graft Rejection
Meta-Analysis
Cohort Studies
Retrospective Studies

ASJC Scopus subject areas

  • Nephrology

Cite this

Mohan, S., Palanisamy, A., Tsapepas, D., Tanriover, B., Crew, R. J., Dube, G., ... Radhakrishnan, J. (2012). Donor-specific antibodies adversely affect kidney allograft outcomes. Journal of the American Society of Nephrology, 23(12), 2061-2071. https://doi.org/10.1681/ASN.2012070664

Donor-specific antibodies adversely affect kidney allograft outcomes. / Mohan, Sumit; Palanisamy, Amudha; Tsapepas, Demetra; Tanriover, Bekir; Crew, R. John; Dube, Geoffrey; Ratner, Lloyd E.; Cohen, David J.; Radhakrishnan, Jai.

In: Journal of the American Society of Nephrology, Vol. 23, No. 12, 2012, p. 2061-2071.

Research output: Contribution to journalArticle

Mohan, S, Palanisamy, A, Tsapepas, D, Tanriover, B, Crew, RJ, Dube, G, Ratner, LE, Cohen, DJ & Radhakrishnan, J 2012, 'Donor-specific antibodies adversely affect kidney allograft outcomes', Journal of the American Society of Nephrology, vol. 23, no. 12, pp. 2061-2071. https://doi.org/10.1681/ASN.2012070664
Mohan, Sumit ; Palanisamy, Amudha ; Tsapepas, Demetra ; Tanriover, Bekir ; Crew, R. John ; Dube, Geoffrey ; Ratner, Lloyd E. ; Cohen, David J. ; Radhakrishnan, Jai. / Donor-specific antibodies adversely affect kidney allograft outcomes. In: Journal of the American Society of Nephrology. 2012 ; Vol. 23, No. 12. pp. 2061-2071.
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