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Clinical Significance of De Novo Donor Specific Antibody Based on the Type of Kidney Transplantation

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Author(s)
Woo Yeong ParkYaerim KimJin Hyuk PaekKyubok JinSeungyeup Han
Keimyung Author(s)
Park, Woo YoungKim, Yae RimPaek, Jin HyukJin, Kyu BokHan, Seung Yeup
Department
Dept. of Internal Medicine (내과학)
Journal Title
Transplant Proc
Issued Date
2022
Volume
54
Issue
2
Abstract
Background:
Preemptive living donor kidney transplantation (P-LDKT) has shown a better prognosis than nonpreemptive living donor KT (NP-LDKT) or deceased donor KT (DDKT). However, association between KT type and de novo donor specific antibody (dnDSA) is uncertain.

Materials:
We retrospectively analyzed 1114 patients who underwent KT between 1994 and 2020. We investigated the clinical significance of dnDSA based on KT type.

Results:
Mean follow-up duration was 131.5 ± 89.5 months. Mean age of recipients, mismatched number of human leukocyte antigens and incidence of delayed graft function were significantly higher in DDKT group than P-LDKT and NP-LDKT groups. There were no significant differences of incidence of dnDSA and acute rejection within 1 year among them. Death-censored graft survival rate was significantly lower in all groups with dnDSA than without dnDSA, respectively. In positive dnDSA, NP-LDKT and DDKT groups tended to be lower in the death-censored graft survival compared to P-LDKT and there was a significant interaction between type of KT and dnDSA ( P = .010). Independent risk factors were acute rejection within 1 year (hazard ratio [HR], 4.341; 95% CI, 1.758-10.720; P = .001), dnDSA positivity (HR, 3.170; 95% CI, 1.364-7.371; P = .007), and eGFR at 12 months after KT (HR, 3.701; 95% CI 2.049-6.686; P < .001).

Conclusions:
There was no significant difference of incidence of dnDSA based on KT type, but allograft survival was poor in all recipients with dnDSA. NP-LDKT and DDKT with dnDSA showed poor prognosis compared to P-LDKT with dnDSA. Therefore, continuous and rigorous surveillance of DSA needs among NP-LDKT and DDKT.
Keimyung Author(s)(Kor)
박우영
김예림
백진혁
진규복
한승엽
Publisher
School of Medicine (의과대학)
Citation
Woo Yeong Park et al. (2022). Clinical Significance of De Novo Donor Specific Antibody Based on the Type of Kidney Transplantation. Transplant Proc, 54(2), 335–340. doi: 10.1016/j.transproceed.2022.01.001
Type
Article
ISSN
0041-1345
Source
https://www.clinicalkey.com/#!/content/playContent/1-s2.0-S0041134522000045
DOI
10.1016/j.transproceed.2022.01.001
URI
https://kumel.medlib.dsmc.or.kr/handle/2015.oak/44221
Appears in Collections:
1. School of Medicine (의과대학) > Dept. of Internal Medicine (내과학)
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