Impact of donor-specific antibody with low mean fluorescence intensity on allograft outcomes in kidney transplant
Issued Date
2024-06-01
Resource Type
ISSN
09663274
eISSN
18785492
Scopus ID
2-s2.0-85193299185
Journal Title
Transplant Immunology
Volume
84
Rights Holder(s)
SCOPUS
Bibliographic Citation
Transplant Immunology Vol.84 (2024)
Suggested Citation
Kitpermkiat R., Kantachuvesiri S., Thotsiri S., Thammanichanond D., Rostaing L., Wiwattanathum P. Impact of donor-specific antibody with low mean fluorescence intensity on allograft outcomes in kidney transplant. Transplant Immunology Vol.84 (2024). doi:10.1016/j.trim.2024.102054 Retrieved from: https://repository.li.mahidol.ac.th/handle/20.500.14594/98461
Title
Impact of donor-specific antibody with low mean fluorescence intensity on allograft outcomes in kidney transplant
Corresponding Author(s)
Other Contributor(s)
Abstract
Background: Immune-mediated rejection is the most common cause of allograft failure in kidney transplant (KT) patients. Exposure to alloantigen, including human leukocyte antigen (HLA), results in the production of donor-specific antibodies (DSA). There are limited data about low levels of mean fluorescence intensity (MFI) DSA, especially post-transplantation. This study evaluated allograft outcomes in KT patients with low MFI DSA. Methods: From January 2007 to December 2021, KT patients who were tested for post-transplant DSA at Ramathibodi Hospital, Bangkok, Thailand, with the DSA MFI ≤ 1000 were evaluated. These KT patients were categorized into two groups: very low DSA (VLL; MFI = 1–500) and low DSA (LL; MFI = 501–1000). All KT patients were evaluated for the primary outcomes, such as the incidence of acute rejection, serum creatinine levels at one and five years after transplantation as well as allograft and patient survivals. Results: Among 36 KT patients 25 were included as those with VLL and 11 as those with LL. The LL group had significantly higher T-cell mediated allograft rejection (TCMR) than the VLL group (45% vs. 12%, P = 0.04). In addition, 10 patients, 5 in the VLL group and 5 in the LL group developed antibody-mediated allograft rejection (ABMR). Both TCMR and ABMR were confirmed by biopsy results. There was a trend toward higher MFI in KT patients with ABMR than without ABMR (P = 0.22). At 5 post-transplant years, serum creatinine, allograft and patient survivals were comparable between these two groups. Furthermore, the univariate and multivariate analyzes revealed that the LL group was a high risk for rejection. Conclusion: Low MFI DSA values after transplantation may be associated with a higher incidence of rejection, but this finding did not show differences in allograft and patient survival in this study's analysis.