Pediatric kidney recipients may benefit from monitoring for donor-specific antibodies

Deepa Athavale, Judith Worthington, Nicholas J A Webb, Denise Roberts, Susan Martin, Mohan Shenoy

    Research output: Contribution to journalArticlepeer-review

    Abstract

    There are limited data regarding the presence of DSAs and their effect on graft function in pediatric renal transplantation. The role for serial DSA monitoring in routine clinical practice is unclear. All patients attending a regional transplant clinic were tested for DSAs, measured using Luminex single/mixed antigen beads. Any patient having a positive result subsequently underwent historic testing on samples previously obtained. DSA-positive patients underwent prospective monitoring of DSAs, and correlation with clinical events was studied. Nine of a total of 50 patients (18%) were DSA-positive, of whom six had graft dysfunction. The DSA-positive cohort had significantly increased episodes of AR (p = 0.01). There were two graft losses in the DSA-positive group and none in the DSA-negative group. Eight of the DSA-positive group had potentially reduced exposure to IS because of either adherence issues or clinical indications. DSAs were associated with increased risk of rejection. There appears to be a role for serial monitoring of DSAs in patients where there has been a reduced exposure to IS so that early intervention with optimized IS can be considered. © 2014 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.
    Original languageEnglish
    Pages (from-to)258-265
    Number of pages7
    JournalPediatric transplantation
    Volume18
    Issue number3
    DOIs
    Publication statusPublished - 2014

    Keywords

    • acute rejection
    • donor-specific antibody
    • immunosuppression
    • serial DSA monitoring

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