Post-transplant DSA monitoring may predict antibody-mediated rejection in sensitized kidney transplant recipients.

Maha A. Mohamed, Brenda Muth, Vijay Vidyasagar, David Foley, Luis Fernandez, R. Michael Hofmann, Josh Mezrich, John Pirsch, Jon Odorico, Tony d'Alessandro, Janet Bellingham, Jose Torrealba, Dixon Kaufman, Arjang Djamali

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Abstract

We examined whether changes in posttransplant highest intensity donor specific anti-HLA antibody specificity (DSAmax) measured by single antigen bead via Luminex (One Lambda, Inc.) were associated with antibody-mediated rejection (AMR). We conducted a retrospective analysis examining risk factors for AMR in 116 consecutive patients who underwent desensitization between 1/1/2009 and 9/1/2010. All patients had a negative flow cytometry crossmatch. The mean patient age at transplant was 46.4 +/- 4 years. The mean peak PRA (panel reactive antibody) and DSAmax at transplant were 40 +/- 6% and 894 +/- 150 mean fluorescent intensity (MFI), respectively. The mean time to rejection was 1.5 +/- 0.4 months. Cox regression analyses demonstrated that an increase in DSAmax by one week after transplant was significantly associated with AMR (pure or mixed). A rise in DSAmax greater than 500 MFI at 1 week was associated with a 2.6 times greater risk of rejection (HR 2.6, 95% CI 1.1 - 6.3, p = 0.02). We conclude that a rise in DSAmax at one week is an independent risk factor forAMR and that posttransplant DSA monitoring strategies may reduce the risk of AMR in sensitized patients.

Original languageEnglish (US)
Pages (from-to)389-394
Number of pages6
JournalClinical transplants
StatePublished - 2011

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Transplants
Kidney
Antibodies
Antibody Specificity
Anti-Idiotypic Antibodies
Flow Cytometry
Regression Analysis
Transplant Recipients
Tissue Donors
Antigens

ASJC Scopus subject areas

  • Medicine(all)

Cite this

Mohamed, M. A., Muth, B., Vidyasagar, V., Foley, D., Fernandez, L., Hofmann, R. M., ... Djamali, A. (2011). Post-transplant DSA monitoring may predict antibody-mediated rejection in sensitized kidney transplant recipients. Clinical transplants, 389-394.

Post-transplant DSA monitoring may predict antibody-mediated rejection in sensitized kidney transplant recipients. / Mohamed, Maha A.; Muth, Brenda; Vidyasagar, Vijay; Foley, David; Fernandez, Luis; Hofmann, R. Michael; Mezrich, Josh; Pirsch, John; Odorico, Jon; d'Alessandro, Tony; Bellingham, Janet; Torrealba, Jose; Kaufman, Dixon; Djamali, Arjang.

In: Clinical transplants, 2011, p. 389-394.

Research output: Contribution to journalArticle

Mohamed, MA, Muth, B, Vidyasagar, V, Foley, D, Fernandez, L, Hofmann, RM, Mezrich, J, Pirsch, J, Odorico, J, d'Alessandro, T, Bellingham, J, Torrealba, J, Kaufman, D & Djamali, A 2011, 'Post-transplant DSA monitoring may predict antibody-mediated rejection in sensitized kidney transplant recipients.', Clinical transplants, pp. 389-394.
Mohamed MA, Muth B, Vidyasagar V, Foley D, Fernandez L, Hofmann RM et al. Post-transplant DSA monitoring may predict antibody-mediated rejection in sensitized kidney transplant recipients. Clinical transplants. 2011;389-394.
Mohamed, Maha A. ; Muth, Brenda ; Vidyasagar, Vijay ; Foley, David ; Fernandez, Luis ; Hofmann, R. Michael ; Mezrich, Josh ; Pirsch, John ; Odorico, Jon ; d'Alessandro, Tony ; Bellingham, Janet ; Torrealba, Jose ; Kaufman, Dixon ; Djamali, Arjang. / Post-transplant DSA monitoring may predict antibody-mediated rejection in sensitized kidney transplant recipients. In: Clinical transplants. 2011 ; pp. 389-394.
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