Médecine moléculaire et génétique

Significance of De novo Donor-Specific Anti-HLA Antibodies in Renal Transplantation: A Single Center Experience

Abstract

Kozaki K, Adachi N, Sasaki T, Okada A, Kato T, Yuzawa K, Inadome Y and Terashima T

T cell-mediated rejection (TCMR) became controllable, and the long-term renal graft survival came to be obtained by the recent progress and innovation of the immuno-suppressants. Whereas the prophylaxis and control of antibody-mediated rejection (ABMR) caused by donor-specific anti-HLA antibody (DSA) are still insufficient and affect the long-term renal graft survival. DSA was classified roughly as follows: preexisting DSA existed in the patients before renal transplantation (RTx), and de novo DSA produced in the patients after RTx. There are many reports about the effect that preexisting DSA gives to a renal graft, and the treatment for ABMR with preexisting DSA is established to some degree. In contrast to preexisting DSA, it cannot be said that de novo DSA are considered enough at present. In this study, we examined the impact that de novo DSA gave to a renal graft in 40 RTx patients under treatment in our hospital. Although there was no significant difference as to the renal graft function in DSA positive and negative group, the renal graft survival showed the tendency that was better in a DSA negative group than a positive group (85% vs. 55%, P=0.0553). We perform monitoring of the de novo DSA positively and should contribute to the prognosis improvement of the renal graft in future.