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http://hdl.handle.net/2445/172488
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DC Field | Value | Language |
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dc.contributor.author | Meneghini, Maria | - |
dc.contributor.author | Melilli, Edoardo | - |
dc.contributor.author | Martorell, Jaume | - |
dc.contributor.author | Revuelta, Ignacio | - |
dc.contributor.author | Rigol Monzó, Elisabet | - |
dc.contributor.author | Manonelles, Anna | - |
dc.contributor.author | Montero, Nuria | - |
dc.contributor.author | Cucchiari, David | - |
dc.contributor.author | Diekmann, Fritz | - |
dc.contributor.author | Cruzado, Josep Ma. | - |
dc.contributor.author | Gil-Vernet, Salvador | - |
dc.contributor.author | Grinyó Boira, Josep M. | - |
dc.contributor.author | Bestard Matamoros, Oriol | - |
dc.date.accessioned | 2020-12-01T13:59:28Z | - |
dc.date.available | 2020-12-01T13:59:28Z | - |
dc.date.issued | 2018 | - |
dc.identifier.issn | 2468-0249 | - |
dc.identifier.uri | http://hdl.handle.net/2445/172488 | - |
dc.description.abstract | Introduction: Despite the different assays available for immune-risk stratification before living-donor kidney transplantation (LDKT), the precise type and number of tests to perform remain uncertain. Methods: In a cohort of 330 consecutive LDKT patients, all of which were complement-dependent cyto- toxicity (CDC) crossmatch negative, we retrospectively analyzed the impact on main clinical outcomes of most sensitive immunoassays (complement-dependent cytotoxicity panel-reactive antibody [CDC-PRA], flow cytometry crossmatch [FC-XM], donor-specific antibodies [DSAs], and their complement-binding capacity DSA-C3d]), together with donor/recipient HLA eplet matching. Mean follow-up was 67 months (range 24 190 months). Results: Of 330 patients, 35 (11%) showed a CDC-PRA >20%; 17 (5%) FC-XMþ; 30 (9%) DSAþ, 18(5%) DSA- C3dþ, with low overlapping results (10 patients positive in all donor-specific tests). Unlike HLA allele compatibility, the mean number of HLA class II eplet mismatches was higher in LDKT patients with positive baseline test results. DSA-C3dþ showed higher mean fluorescence intensity (MFI) DSA, with a cut-off MFI of 6192 accurately predicting complement fixation (area under the curve 1⁄4 0.85, P 1⁄4 0.008). Although all assays were associated with acute rejection (AR), only DSA-C3dþ (odds ratio [OR] 1⁄4 6.64, P 1⁄4 0.038) or high MFI-DSA (OR 1⁄4 7.54, P 1⁄4 0.038) independently predicted AR. Likewise, poorly HLA class II eplet matched patients were at higher risk for AR, particularly patients with negative baseline test results (OR 1⁄4 1.14, P 1⁄4 0.019). Finally, previous AR and FC-XMþ/DSAþ, regardless of C3d positivity, indepen- dently predicted graft loss. Conclusion: Combining FC-XM and solid-phase assays with the evaluation of donor/recipient HLA eplet mismatches, are most accurate tools for immune-risk stratification prior LDKT. | - |
dc.format.extent | 13 p. | - |
dc.format.mimetype | application/pdf | - |
dc.language.iso | eng | - |
dc.publisher | Elsevier | - |
dc.relation.isformatof | Reproducció del document publicat a: https://doi.org/10.1016/j.ekir.2018.03.015 | - |
dc.relation.ispartof | Kidney International Reports, 2018, vol. 3, num. 4, p. 926-938 | - |
dc.relation.uri | https://doi.org/10.1016/j.ekir.2018.03.015 | - |
dc.rights | cc-by-nc-nd (c) International Society of Nephrology, 2018 | - |
dc.rights.uri | http://creativecommons.org/licenses/by-nc-nd/3.0/es | - |
dc.source | Articles publicats en revistes (Ciències Clíniques) | - |
dc.subject.classification | Trasplantament renal | - |
dc.subject.classification | Leucòcits | - |
dc.subject.classification | Antígens | - |
dc.subject.other | Kidney transplantation | - |
dc.subject.other | Leucocytes | - |
dc.subject.other | Antigens | - |
dc.title | Combining sensitive crossmatch assays with donor/recipient human leukocyte antigen eplet matching predicts living-donor kidney transplant outcome | - |
dc.type | info:eu-repo/semantics/article | - |
dc.type | info:eu-repo/semantics/publishedVersion | - |
dc.identifier.idgrec | 682587 | - |
dc.date.updated | 2020-12-01T13:59:28Z | - |
dc.rights.accessRights | info:eu-repo/semantics/openAccess | - |
dc.identifier.pmid | 29989033 | - |
Appears in Collections: | Articles publicats en revistes (Ciències Clíniques) Articles publicats en revistes (Institut d'lnvestigació Biomèdica de Bellvitge (IDIBELL)) |
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