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- Title
Predictive factors of allosensitization in renal transplant patients switched from calcineurin to m TOR inhibitors.
- Authors
Ruiz San Millán, Juan Carlos; López-Hoyos, Marcos; Segundo, David San; Quintela, Estrella; Rodrigo, Emilio; Gómez-Alamillo, Carlos; Romón, Iñigo; Arias, Manuel
- Abstract
Conversion of kidney-transplant recipients from calcineurin inhibitors to m TOR inhibitors has been suggested to be a risk factor for increased alloimmune response. We have analyzed the development of new HLA-antibodies ( HLA-Abs) early after conversion in 184 patients converted in stable phase at our hospital and compared with a control group of nonconverted comparable 63 transplants. Using single-antigen solid-phase immunoassay analysis, a preconversion and a 3-6 months postconversion sera were prospectively analyzed in every patient for the appearance of new HLA-Abs. Renal function at 2 years postconversion and cumulative graft survival were compared between groups. In 16 patients, new HLA-Abs (3- DSA and 13-Non DSA), not present at the moment of conversion, were detected (8.7% vs. 3.1% in the control group). The type of m TORi used, type of CNI preconversion, the presence of steroids, time of conversion, or indication for conversion did not have influence on this effect but the presence of HLA-Abs before conversion highly correlated with the appearance of new specificities. Patients with de novo HLA-Abs showed a trend to worst graft function and survival. In conclusion, conversion to m TORi can be followed by early appearance of de novo HLA-Abs, especially in patients with HLA-Abs preconversion, and this complication should be screened early after conversion.
- Subjects
CALCINEURIN; KIDNEY transplantation; ANTIGENS; IMMUNOASSAY; STEROIDS
- Publication
Transplant International, 2014, Vol 27, Issue 8, p847
- ISSN
0934-0874
- Publication type
Article
- DOI
10.1111/tri.12334