Donor human leukocyte antigen specific antibodies predict development and define prognosis in transplant glomerulopathy

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dc.contributor.authorEng, H.
dc.contributor.authorBennett, G.
dc.contributor.authorChang, S.
dc.contributor.authorDent, H.
dc.contributor.authorMcDonald, S.
dc.contributor.authorBardy, P.
dc.contributor.authorCoghlan, P.
dc.contributor.authorRuss, G.
dc.contributor.authorCoates, P.
dc.date.issued2011
dc.description.abstractThe pathogenesis of transplant glomerulopathy (TG) remains unclear, with evidence of human leukocyte antigen (HLA) antibodies as important contributors to the disease. We studied the risk factors and the associations of HLA antibodies in the development of TG. Sixty-one cases with morphologic features of TG were identified and compared with contemporaneous matched patients (without TG) from a 17-year period, all undergoing renal biopsy in a single center. Univariate risk factors for TG were previous glomerulitis [odds ratio (OR) 3.3, 95% confidence interval (95% CI) [1.2-9.4], p = 0.025), delayed graft function (OR 2.3 [1.0-5.1], p = 0.042), HLA class I presensitization defined by Luminex solid-phase immunoassays (OR 5.0 [2.3-11.0]. p < 0.001), and de novo posttransplant development of donor HLA specific antibody (DSA) (OR 4.7 [1.7-13.2], p = 0.002). Only DSA remained significantly associated with TG after adjustment (OR 3.8 [1.1-12.9], p = 0.032). DSA was detected in >50% of TG patients, suggesting HLA antibodies play a critical role in TG pathogenesis. TG patients with DSA had increased risk of graft loss (median graft survival 4.4-5.2 years), whereas patients with morphologic features of TG without DSA had similar graft survival compared with the non-TG group (median graft survival 15 years). Thus, DSA is a useful predictor for graft failure in TG patients.
dc.description.statementofresponsibilityHooi Sian Eng, Greg Bennett, Sean H. Chang, Hannah Dent, Stephen P. McDonald, Peter Bardy, Patrick Coghlan, Graeme R. Russ, P. Toby H. Coates
dc.identifier.citationHuman Immunology, 2011; 72(5):386-391
dc.identifier.doi10.1016/j.humimm.2011.02.002
dc.identifier.issn0198-8859
dc.identifier.issn1879-1166
dc.identifier.orcidMcDonald, S. [0000-0001-6103-1386]
dc.identifier.urihttp://hdl.handle.net/2440/66886
dc.language.isoen
dc.publisherElsevier Science Inc
dc.rightsCrown copyright © 2011 Published by Elsevier Inc. All rights reserved.
dc.source.urihttps://doi.org/10.1016/j.humimm.2011.02.002
dc.subjectHLA antibodies
dc.subjectRenal transplant
dc.subjectGlomerulopathy
dc.titleDonor human leukocyte antigen specific antibodies predict development and define prognosis in transplant glomerulopathy
dc.typeJournal article
pubs.publication-statusPublished

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