Timing of anti-donor antibody responses affects the survival of kidney transplants

March 2, 2017

New research provides insights on transplant recipients' antibody responses against donor kidneys and how the timing of those responses can have important implications. The findings appear in an upcoming issue of the Journal of the American Society of Nephrology (JASN).

An antibody response against donor organs is the main cause of following transplantation. Antibodies can occur in 2 scenarios: before transplantation (pre-existing donor-specific antibodies) and after transplantation (de novo donor-specific antibodies). Little is known about how these processes compare.

Understanding the role of antibodies in rejection is needed to guide matching of donors and recipients and to better prevent rejection. A team led by Alexandre Loupy, MD, PhD, Olivier Aubert, MD (INSERM U 970, Paris Translational Research Center for Organ Transplantation, in France), and Phil Halloran, MD, PhD (Alberta Transplant Applied Genomics Centre, in Canada) studied 205 patients who experienced antibody-mediated rejection following : 103 patients had pre-existing donor-specific antibodies and 102 patients had de novo donor-specific antibodies.

There were various differences between patients with pre-existing vs. de novo donor-specific antibodies, but the most striking was the superior kidney survival experienced by the pre-existing group compared with the de novo group (63% vs. 34% at 8 years after rejection, respectively), regardless of treatment.

"Our study highlights that rejection due to antibodies that were present before transplantation is linked with a significantly better outcome that rejection due to de novo donor-specific antibodies," said Dr. Aubert.

"Our results encourage the transplantation of patients who have antibodies before transplant. These patients would not normally have been considered as good candidates for transplantation and would have stayed on dialysis because of a high level of sensitization that prevents from finding a compatible kidney," said Dr. Loupy. The findings also indicate the need to closely monitor patients for the development of de novo donor-specific antibodies so that therapies can be initiated to preserve kidney function.

Explore further: Antibodies in the blood provide clues to transplant recipients' likelihood of rejection

More information: "Antibody-Mediated Rejection Due to Preexisting versus De Novo Donor-Specific Antibodies in Kidney Allograft Recipients," DOI: 10.1681/ASN.2016070797

Related Stories

Antibodies in the blood provide clues to transplant recipients' likelihood of rejection

August 20, 2015
The dominant antibody type present in the blood of transplant recipients may indicate their likelihood of experiencing organ rejection, according to a study appearing in an upcoming issue of the Journal of the American Society ...

Antibody response may lead to narrowed arteries and organ rejection

April 14, 2011
Kidney transplant recipients who develop antibodies in response to receiving new organs can develop accelerated arteriosclerosis, or narrowing of the arteries that supply blood to the kidney, according to a study appearing ...

Viral infection in transplant recipients increases risk of developing damaging antibodies

September 25, 2014
Kidney transplant recipients infected with BK virus are more likely to develop antibodies against their kidney transplants than uninfected patients, according to a study appearing in an upcoming issue of the Journal of the ...

Low levels of donor-specific antibodies increase risks for transplant recipients

November 15, 2012
Kidney transplant recipients who have even very low levels of preformed antibodies directed against a donated kidney have a significantly increased risk of organ rejection and kidney failure, according to a study appearing ...

Long-term benefits to the liver-kidney transplant

April 15, 2016
A new study from physicians at Mayo Clinic in Rochester, found there may be long-term benefits to simultaneous liver-kidney transplantation versus kidney transplantation alone. The study, "Decreased Chronic Cellular and Antibody-Mediated ...

HIV+ kidney failure patients face hurdles in receiving necessary transplants

February 23, 2017
A new study finds that HIV-infected individuals with kidney failure are less likely to receive a kidney transplant—especially from living donors—than their uninfected counterparts. The study appears in an upcoming issue ...

Recommended for you

Exploring the potential of human echolocation

June 25, 2017
People who are visually impaired will often use a cane to feel out their surroundings. With training and practice, people can learn to use the pitch, loudness and timbre of echoes from the cane or other sounds to navigate ...

Team eradicates hepatitis C in 10 patients following lifesaving transplants from infected donors

April 30, 2017
Ten patients at Penn Medicine have been cured of the Hepatitis C virus (HCV) following lifesaving kidney transplants from deceased donors who were infected with the disease. The findings point to new strategies for increasing ...

'bench to bedside to bench': Scientists call for closer basic-clinical collaborations

March 24, 2017
In the era of genome sequencing, it's time to update the old "bench-to-bedside" shorthand for how basic research discoveries inform clinical practice, researchers from The Jackson Laboratory (JAX), National Human Genome Research ...

The ethics of tracking athletes' biometric data

January 18, 2017
(Medical Xpress)—Whether it is a FitBit or a heart rate monitor, biometric technologies have become household devices. Professional sports leagues use some of the most technologically advanced biodata tracking systems to ...

Financial ties between researchers and drug industry linked to positive trial results

January 18, 2017
Financial ties between researchers and companies that make the drugs they are studying are independently associated with positive trial results, suggesting bias in the evidence base, concludes a study published by The BMJ ...

Best of Last Year – The top Medical Xpress articles of 2016

December 23, 2016
(Medical Xpress)—It was a big year for research involving overall health issues, starting with a team led by researchers at the UNC School of Medicine and the National Institutes of Health who unearthed more evidence that ...

0 comments

Please sign in to add a comment. Registration is free, and takes less than a minute. Read more

Click here to reset your password.
Sign in to get notified via email when new comments are made.