Pre-Transplant Angiotensin II Type 1 Receptor Antibodies and Anti-Endothelial Cell Antibodies Predict Graft Function and Allograft Rejection in a Low-Risk Kidney Transplantation Setting

Shinae Yu; Hee Jae Huh; Kyo Won Lee; Jae Berm Park; Sung Joo Kim; Wooseong Huh; Hye Ryoun Jang; Ghee Young Kwon; Hyung Hwan Moon; Eun-Suk Kang

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자료유형: 학술저널

저자정보: Shinae Yu (Inje University) Hee Jae Huh (Samsung Medical Center) Kyo Won Lee (Samsung Medical Center) Jae Berm Park (Samsung Medical Center) Sung Joo Kim (Samsung Medical Center) Wooseong Huh (Samsung Medical Center) Hye Ryoun Jang (Samsung Medical Center) Ghee Young Kwon (Samsung Medical Center) Hyung Hwan Moon (Samsung Medical Center) Eun-Suk Kang (Kosin University)

저널정보: 대한진단검사의학회 Annals of Laboratory Medicine Annals of Laboratory Medicine 제40권 제5호

발행연도: 2020.1

수록면: 398 - 408 (11page)

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Background: Non-HLA antibodies, anti-angiotensin II type 1 receptor antibodies (anti-AT1R) and anti-endothelial cell antibodies (AECA), are known to play a role in allograft rejection. We evaluated the role of both antibodies in predicting post-transplant outcomes in low-risk living donor kidney transplantation (LDKT) recipients. Methods: In 94 consecutive LDKT recipients who were ABO compatible and negative for pre-transplant HLA donor-specific antibodies, we determined the levels of anti-AT1Rs using an enzyme-linked immunosorbent assay and the presence of AECAs using a flow cytometric endothelial cell crossmatch (ECXM) assay with pre-transplant sera. Hazard ratio (HR) was calculated to predict post-transplant outcomes. Results: Pre-transplant anti-AT1Rs (≥11.5 U/mL) and AECAs were observed in 36 (38.3%) and 22 recipients (23.4%), respectively; 11 recipients had both. Pre-transplant anti-AT1Rs were a significant risk factor for the development of acute rejection (AR) (HR 2.09; P=0.018), while a positive AECA status was associated with AR or microvascular inflammation only (HR 2.47; P=0.004) throughout the follow-up period. In particular, AECA (+) recipients with ≥11.5 U/mL anti-AT1Rs exhibited a significant effect on creatinine and estimated glomerular filtration rate (P<0.001; P=0.028), although the risk of AR was not significant. Conclusions: Pre-transplant anti-AT1Rs and AECAs have independent negative effects on post-transplant outcomes in low-risk LDKT recipients. Assessment of both antibodies would be helpful in stratifying the pre-transplant immunological risk, even in low-risk LDKT recipients.

#Non-HLA antibodies #Anti- angiotensin II type 1 receptor antibodies #Anti-endothelial cell antibodies #Endothelial cell crossmatch #Kidney transplantation #Outcome #Low-risk

참고문헌 (27)

참고문헌 신청

Terasaki PI / 2003 / Humoral theory of transplantation / Am J Transplant 3:665~673

Opelz G / 2005 / Non-HLA transplantation immunity revealed by lymphocytotoxic antibodies / Lancet 365:1570~1576

Han F / 2009 / Pre-transplant serum concentrations of anti-endothelial cell antibody in panel reactive antibody negative renal recipients and its impact on acute rejection / Clin Chem Lab Med 47:1265~1269

Breimer ME / 2009 / Multicenter evaluation of a novel endothelial cell crossmatch test in kidney transplantation / Transplantation 87:549~556

Xavier P / 2011 / XM-ONE detection of endothelium cell antibodies identifies a subgroup of HLA-antibody negative patients undergoing acute rejection / Transplant Proc 43:91~94

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소속기관 성균관대학교 의과대학 진단검사의학교실

주요연구분야 의약학 > 임상의학 > 임상병리학

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주요연구분야 의약학 > 의학 일반 자연과학 > 기타 자연과학

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Kyo Won Lee