14th International HLA and Immunogenetics Workshop Prospective Chronic Rejection Project: A Three-year Follow-up Analysis.

Ozawa M, Terasaki PI, Castro R, Alberu J, Morales-Buenrostro L, Alvarez I, Toledo R, Alvez H, Monteiro M, Teixeira J, Campbell P, Ciszek M, Charron D, Gautreau C, Christiansen F, Langan L, Conca R, Grosse-Wilde H, Heinemann F, Kamoun M, Kobayashi T, Kupatawintu P, LeFor W, Mehra N, Panigrahi A, Norman D, Piazza A, Poli F, Roy R, Schonemann C, Lachmann N, Sireci G, Tanabe K, Ishida H, Van den Berg-Loonen E, Zeevi A.

Clinical Transplants 2007, Chapter 26

Abstract

The three-year follow-up of 4,144 patients of the 14th International Workshop Prospective Chronic Rejection study has reinforced the evidence that post-transplant HLA antibodies are predictive of long-term graft loss. Three years after a single testing for HLA antibodies, 10% of kidney recipients who were antibody-positive had lost their grafts, in contrast to only 5% of antibody-negative patients (p<0.0001). The adverse effect of post-transplant antibodies on graft survival was also observed in lung, heart, and liver transplants. Donor-specific antibodies and 'strong' non-DSA had stronger association with graft loss than 'moderate' non-DSA. Periodic antibody monitoring, combined with specificity and strength analysis, would help in the early identification of allograft recipients who are at high risk of graft failure.