http://www.cnr.it/ontology/cnr/individuo/prodotto/ID192382
C1Q-FIXING HLA ANTIBODIES AND KIDNEY TRANSPLANTATION (Abstract/Comunicazione in rivista)
- Type
- Label
- C1Q-FIXING HLA ANTIBODIES AND KIDNEY TRANSPLANTATION (Abstract/Comunicazione in rivista) (literal)
- Anno
- 2012-01-01T00:00:00+01:00 (literal)
- Alternative label
Elvira Poggi 1, Giuseppina Ozzella 1, Daniela
Caputo 2, Rosa Cremona 2, Cecilia Palombi 2, Annarita Manfreda 2, Domenico Adorno 2, Antonina Piazza 1. (2012)
C1Q-FIXING HLA ANTIBODIES AND KIDNEY TRANSPLANTATION
(literal)
- Http://www.cnr.it/ontology/cnr/pubblicazioni.owl#autori
- Elvira Poggi 1, Giuseppina Ozzella 1, Daniela
Caputo 2, Rosa Cremona 2, Cecilia Palombi 2, Annarita Manfreda 2, Domenico Adorno 2, Antonina Piazza 1. (literal)
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- oral presentation (literal)
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- Comunicazione (literal)
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- 1 Institute of Translational Pharmacology, Unit of Rome S. Camillo Hospital, National Council of Researches,
Rome, Italy; 2 Regional Transplant Center of Lazio, Tor Vergata University of Rome, Rome, Italy. (literal)
- Titolo
- C1Q-FIXING HLA ANTIBODIES AND KIDNEY TRANSPLANTATION (literal)
- Abstract
- Aim: De novo production of donor-specific HLA antibodies (DSA) represents the major risk factor of graft
failure in kidney transplantation. However, some patients show persistent presence of circulating DSA without
occurrence of graft dysfunction/loss. Newer solid phase assay Luminex Single Antigen (LSA) beads, is
highly sensitive respect to complement-dependent citotoxicity assay but less predictive of transplant outcome
because of detection of both complement-fixing and less clinically relevant no complement-fixing
HLA antibodies.
Methods: Using Class I and II C1q-LSA assay (One Lambda,CA), that identifies antibodies able to fix C1q, we
investigate the clinical relevance of de novo HLA-DSA in 40 kidney transplanted patients. As for transplant
outcome, 22 patients suffered graft failure (within 10 ± 1 months from DSA appearance) and 18 had good graft
function during all the follow up (mean 54 ± 34 months from DSA appearance).
Results: Twenty-three patients showed production of C1q-positive DSA while 17 produced C1q-negative
DSA. Correlating graft outcome and capability of DSA to fix C1q, graft failure occurred in 20/23 C1q-positive
DSA patients; only 2/17 C1q-negative DSA patients suffered graft failure (87% vs.12%, P < 0.0001; RR = 7.39;
Sensitivity = 0.91; Specificity = 0.83; PPV = 0.87; NPV = 0.88). It is to underlay that both C1q-positive and
C1q-negative DSA were mainly specific for DQ donor mismatched molecules (74% vs. 53%); the 53% of
anti-DQ C1q-positive DSA were specific for DQ1 molecules while the 75% of anti-DQ C1q-negative DSA were
specific for DQ2 molecules.
Conclusions: C1q-LSA assay showed the capability to identify the subset of IgG-LSA DSA strongly associated
to antibody-mediated rejection and graft loss in kidney transplantation; moreover, its ability in distinguishing
less harmful no complement-fixing DSA from clinically relevant C1q-fixing DSA, allows to identify
patients that need specific immunosuppressive strategy to prolong graft survival. (literal)
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