Double pretransplant positivity for autoantibodies to LG3 and angiotensin II type 1 receptor is associated with alloimmune vascular injury in kidney transplant recipients
Date
2023
Authors
Carroll, R.
Turgeon, J.
Deayton, S.
Emery, T.
Bilogrevic, F.
Jahan, S.
Rimbaud, A.K.
Georges, B.
Tavares Brum, A.
Hébert, M.J.
Editors
Advisors
Journal Title
Journal ISSN
Volume Title
Type:
Journal article
Citation
Transplantation Direct, 2023; 9(2):E1437-
Statement of Responsibility
Conference Name
Abstract
Background. Both angiotensin II receptor autoantibodies (ATRabs) and autoantibodies to LG3 have been linked to kidney graft rejection with alloimmune vascular injury (AVI). We aimed to examine whether positivity for both anti-LG3 and ATRabs is associated with rejection with AVI in kidney transplant recipients.
Methods. We performed a retrospective cohort study including consecutive kidney transplant recipients between 2013 and 2017 at a single center. The primary outcome was acute rejection with AVI (Banff grade 2 or 3 T-cell-mediated rejection and/or antibody-mediated rejection) in the first 3 mo posttransplant. The secondary outcome was death-censored allograft loss. The independent variables, anti-LG3 and ATRab, were measured pretransplant.
Results. Among the 328 study participants, 68 experienced acute rejection with AVI and 23 experienced graft loss over a median follow-up of 4.5 y. In a multivariable model, double pretransplant positivity for anti-LG3/ATRab was associated with acute rejection with AVI (odds ratio: 2.73, 95% confidence interval: 1.06-7.05). We did not observe an association between double positivity for anti-LG3/ATRab and death-censored graft loss.
Conclusions. Double positivity for anti-LG3/ATRabs pretransplant is associated with a higher risk of acute rejection with AVI. Whether therapies that remove antibodies could decrease that risk remains to be studied.
School/Discipline
Dissertation Note
Provenance
Description
Data source: Supplemental visual abstract, https://links.lww.com/TXD/A494
Access Status
Rights
Copyright 2023 The Author(s). Transplantation Direct. Published by Wolters Kluwer Health, Inc. This is an open-access article distributed under the terms of the Creative Commons Attribution-Non Commercial-No Derivatives License 4.0(CCBY-NC-ND), where it is permissible to download and share the work provided it is properly cited. The work cannot be changed in any way or used commercially without permission from the journal. (https://creativecommons.org/licenses/by-nc-nd/4.0/)