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Journal of Immunology Research
Volume 2017, Article ID 1747030, 9 pages
https://doi.org/10.1155/2017/1747030
Research Article

De Novo Donor-Specific HLA Antibodies Developing Early or Late after Transplant Are Associated with the Same Risk of Graft Damage and Loss in Nonsensitized Kidney Recipients

1Nephrology, Dialysis and Transplantation Unit, IRCCS Istituto G. Gaslini, Genova, Italy
2Clinical Nephrology Unit and Transplant Immunology Research Laboratory, Department of Internal Medicine, University of Genova and IRCCS San Martino University Hospital IST, Genova, Italy
3Transplantation Immunology, IRCCS Fondazione Ca’ Granda, Ospedale Maggiore Policlinico, Milano, Italy
4Pediatric Hematology/Oncology and Cell Factory, Fondazione IRCCS Policlinico S. Matteo, Pavia, Italy
5Vascular and Endovascular Unit and Kidney Transplant Surgery Unit, University of Genova, IRCCS San Martino University Hospital IST, Genova, Italy
6Biometry and Statistics Service, Fondazione IRCCS Policlinico S. Matteo, Pavia, Italy

Correspondence should be addressed to Fabrizio Ginevri; gro.inilsag@irvenigoizirbaf

Received 23 December 2016; Revised 27 January 2017; Accepted 13 February 2017; Published 6 March 2017

Academic Editor: Senthami R. Selvan

Copyright © 2017 Michela Cioni et al. This is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

Abstract

De novo posttransplant donor-specific HLA-antibody (dnDSA) detection is now recognized as a tool to identify patients at risk for antibody-mediated rejection (AMR) and graft loss. It is still unclear whether the time interval from transplant to DSA occurrence influences graft damage. Utilizing sera collected longitudinally, we evaluated 114 consecutive primary pediatric kidney recipients grafted between 2002 and 2013 for dnDSA occurrence by Luminex platform. dnDSAs occurred in 39 patients at a median time of 24.6 months. In 15 patients, dnDSAs developed within 1 year (early-onset group), while the other 24 seroconverted after the first posttransplant year (late-onset group). The two groups were comparable when considering patient- and transplant-related factors, as well as DSA biological properties, including C1q and C3d complement-binding ability. Only recipient age at transplant significantly differed in the two cohorts, with younger patients showing earlier dnDSA development. Late AMR was diagnosed in 47% of the early group and in 58% of the late group. Graft loss occurred in 3/15 (20%) and 4/24 (17%) patients in early- and late-onset groups, respectively ( = ns). In our pediatric kidney recipients, dnDSAs predict AMR and graft loss irrespective of the time elapsed between transplantation and antibody occurrence.