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Complement-Binding Donor-Specific Anti-HLA Antibodies : Biomarker for Immunologic Risk Stratification in Pediatric Kidney Transplantation Recipients

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dc.contributor Landspitali - The National University Hospital of Iceland
dc.contributor.author Sigurjónsdóttir, Vaka Kristín
dc.contributor.author Purington, Natasha
dc.contributor.author Chaudhuri, Abanti
dc.contributor.author Zhang, Bing M.
dc.contributor.author Fernandez-Vina, Marcelo
dc.contributor.author Pálsson, Runólfur
dc.contributor.author Kambham, Neeraja
dc.contributor.author Charu, Vivek
dc.contributor.author Piburn, Kim
dc.contributor.author Maestretti, Lynn
dc.contributor.author Shah, Anika
dc.contributor.author Gallo, Amy
dc.contributor.author Concepcion, Waldo
dc.contributor.author Grimm, Paul C.
dc.date.accessioned 2022-05-18T01:03:08Z
dc.date.available 2022-05-18T01:03:08Z
dc.date.issued 2022-03-16
dc.identifier.citation Sigurjónsdóttir , V K , Purington , N , Chaudhuri , A , Zhang , B M , Fernandez-Vina , M , Pálsson , R , Kambham , N , Charu , V , Piburn , K , Maestretti , L , Shah , A , Gallo , A , Concepcion , W & Grimm , P C 2022 , ' Complement-Binding Donor-Specific Anti-HLA Antibodies : Biomarker for Immunologic Risk Stratification in Pediatric Kidney Transplantation Recipients ' , Transplant International , vol. 35 , 10158 , pp. 10158 . https://doi.org/10.3389/ti.2021.10158
dc.identifier.issn 0934-0874
dc.identifier.other PURE: 48619087
dc.identifier.other PURE UUID: aea4c3fd-47f7-4105-b1a9-6d191f44b4dd
dc.identifier.other Scopus: 85127829167
dc.identifier.uri https://hdl.handle.net/20.500.11815/3184
dc.description Funding Information: VS was a Tashia and John Morgridge Endowed Postdoctoral Fellow of the Stanford Maternal and Child Health Research Institute. VS also received Young Scientist Award at Landspitali–The National University Hospital. Publisher Copyright: Copyright © 2022 Sigurjonsdottir, Purington, Chaudhuri, Zhang, Fernandez-Vina, Palsson, Kambham, Charu, Piburn, Maestretti, Shah, Gallo, Concepcion and Grimm. Copyright © 2022 Sigurjonsdottir, Purington, Chaudhuri, Zhang, Fernandez-Vina, Palsson, Kambham, Charu, Piburn, Maestretti, Shah, Gallo, Concepcion and Grimm.
dc.description.abstract Antibody-mediated rejection is a common cause of early kidney allograft loss but the specifics of antibody measurement, therapies and endpoints have not been universally defined. In this retrospective study, we assessed the performance of risk stratification using systematic donor-specific antibody (DSA) monitoring. Included in the study were children who underwent kidney transplantation between January 1, 2010 and March 1, 2018 at Stanford, with at least 12-months follow-up. A total of 233 patients were included with a mean follow-up time of 45 (range, 9–108) months. Median age at transplant was 12.3 years, 46.8% were female, and 76% had a deceased donor transplant. Fifty-two (22%) formed C1q-binding de novo donor-specific antibodies (C1q-dnDSA). After a standardized augmented immunosuppressive protocol was implemented, C1q-dnDSA disappeared in 31 (58.5%). Graft failure occurred in 16 patients at a median of 54 (range, 5–83) months, of whom 14 formed dnDSA. The 14 patients who lost their graft due to rejection, all had persistent C1q-dnDSA. C1q-binding status improved the individual risk assessment, with persistent; C1q binding yielding the strongest independent association of graft failure (hazard ratio, 45.5; 95% confidence interval, 11.7–177.4). C1q-dnDSA is more useful than standard dnDSA as a noninvasive biomarker for identifying patients at the highest risk of graft failure.
dc.format.extent 10158
dc.language.iso en
dc.relation.ispartofseries Transplant International; 35()
dc.rights info:eu-repo/semantics/openAccess
dc.subject Nýrnalæknisfræði
dc.subject Börn
dc.subject Nýrnaígræðsla
dc.subject antibody-mediated rejection
dc.subject children
dc.subject immunosuppression
dc.subject kidney allograft
dc.subject transplant outcomes
dc.subject Risk Assessment
dc.subject Humans
dc.subject Antibodies
dc.subject Graft Survival
dc.subject Male
dc.subject Complement C1q
dc.subject Kidney Transplantation/adverse effects
dc.subject Biomarkers
dc.subject Female
dc.subject Graft Rejection
dc.subject Antilymphocyte Serum
dc.subject Retrospective Studies
dc.subject HLA Antigens
dc.subject Child
dc.subject Transplantation
dc.title Complement-Binding Donor-Specific Anti-HLA Antibodies : Biomarker for Immunologic Risk Stratification in Pediatric Kidney Transplantation Recipients
dc.type /dk/atira/pure/researchoutput/researchoutputtypes/contributiontojournal/article
dc.description.version Peer reviewed
dc.identifier.pmid 35992747
dc.identifier.doi https://doi.org/10.3389/ti.2021.10158
dc.relation.url http://www.scopus.com/inward/record.url?scp=85127829167&partnerID=8YFLogxK
dc.contributor.department Faculty of Medicine
dc.contributor.department Other departments
dc.contributor.department Office of Division of Clinical Services I


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