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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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