AUTHOR=Laboux Timothée , Lenain Rémi , Visentin Jonathan , Flahaut Gauthier , Chamley Paul , Provôt François , Top Isabelle , Kerleau Clarisse , Labalette Myriam , Choukroun Gabriel , Couzi Lionel , Blancho Gilles , Hazzan Marc , Maanaoui Mehdi 

TITLE=Impact of Preformed Donor-Specific Anti-HLA-Cw and Anti-HLA-DP Antibodies on Acute Antibody-Mediated Rejection in Kidney Transplantation

JOURNAL=Transplant International

VOLUME=Volume 36 - 2023

YEAR=2023

URL=https://www.frontierspartnerships.org/journals/transplant-international/articles/10.3389/ti.2023.11416

DOI=10.3389/ti.2023.11416

ISSN=1432-2277

ABSTRACT=Given the risk of acute rejection, the presence of preformed donor specific antibodies (DSA) antibodies contraindicates transplantation in most allocation systems. However, HLA-Cw and -DP DSA escape this censorship in the French allocation system. Data regarding theses preformed antibodies in kidney transplantation are scarce, especially for DP-DSA. We performed a multicentric retrospective study, studying the risk of acute antibody-mediated rejection (aABMR) in a cohort of 92 and 91 kidney transplant recipients with a preformed Cw-or DP-DSA respectively. At 2 years, the incidence of aABMR was 12% in the Cw-DSA group, versus 28% in the DP-DSA group. Using multivariable Cox regression model, the presence of a preformed DP-DSA was associated with an increased risk of aABMR (HR= 2.32 [1.21-4.45 (p = 0.001)]) compared with Cw-DSA. We report here to our knowledge the largest cohort of patients transplanted in the presence of an isolated preformed DP-DSA, confirming the alleged association of these antibodies with aABMR. Our results may therefore question the need of taking these antibodies into account in the allocation algorithm, in the same way as the other anti-HLA antibodies.