Pretransplant sensitization against angiotensin II type 1 receptor is a risk factor for acute rejection and graft loss

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Item Type:	Article
Title:	Pretransplant sensitization against angiotensin II type 1 receptor is a risk factor for acute rejection and graft loss
Creators Name:	Giral, M., Foucher, Y., Dufay, A., Van Huyen, J.P.D., Renaudin, K., Moreau, A., Philippe, A., Hegner, B., Dechend, R., Heidecke, H., Brouard, S., Cesbron, A., Castagnet, S., Devys, A., Soulillou, J.P. and Dragun, D.
Abstract:	The angiotensin II type 1 receptor (AT1 R) is an emerging target of functional non-HLA antibodies (Ab). We examined the potential of determining the degree of presensitization against AT1 R as a risk factor for graft survival and acute rejection (AR). The study included 599 kidney recipients between 1998 and 2007. Serum samples were analyzed in a blinded fashion for anti-AT1 R antibodies (AT1 R-Abs) using a quantitative solid-phase assay. A threshold of AT1 R-Ab levels was statistically determined at 10 U based on the time to graft failure. An extended Cox model determined risk factors for occurrence of graft failure and a first AR episode. AT1 R-Abs >10 U were detected in 283 patients (47.2%) before transplantation. Patients who had a level of AT1 R-Abs >10 U had a 2.6-fold higher risk of graft failure from 3 years posttransplantation onwards (p = 0.0005) and a 1.9-fold higher risk of experiencing an AR episode within the first 4 months of transplantation (p = 0.0393). Antibody-mediated rejection (AMR) accounted for 1/3 of AR, whereby 71.4% of them were associated with >10 U of pretransplant AT1 R-Abs. Pretransplant anti-AT1 R-Abs are an independent risk factor for long-term graft loss in association with a higher risk of early AR episodes.
Keywords:	Acute Allograft Rejection, Allosensitization, Angiotensin II Receptors, Antibody Mediated Rejection, Pretransplant, Survival
Source:	American Journal of Transplantation
ISSN:	1600-6135
Publisher:	Wiley-Blackwell
Volume:	13
Number:	10
Page Range:	2567-2576
Date:	October 2013
Official Publication:	https://doi.org/10.1111/ajt.12397
PubMed:	View item in PubMed

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