Hernández-Méndez EA, Arreola-Guerra JM, Morales-Buenrostro LE, Ramírez JB, Calleja S, Castelán N, Salcedo I, Vilatobá M, Contreras AG, Gabilondo B, Granados J, Alberú J

Language: Spanish
References: 36
Page: 218-224
PDF size: 150.00 Kb.

ABSTRACT

Angiotensin II type 1 receptor antibodies (AT₁Rab) are associated to a significantly lower graft survival and a higher risk of acute rejection after kidney transplantation. This study aimed to evaluate graft function and BPAR during the 1st year post-transplant (PT) in adult kidney transplant recipients (KTR), between 03/2009 and 08/2012. Pre-KT sera were screened for AT₁Rab (ELISA) and HLA-DSA (Luminex). Three groups were analyzed: AT₁Rab only (n = 13); HLA-DSA only (n = 8); and no AT₁Rab or HLA-DSA (n = 90). No differences were observed in clinical characteristics across groups. A higher percentage of BPAR was observed in the AT₁Rab positive group, but this difference was not significant. KTR with AT₁Rab had a lower mean eGFR (20 mL/min/1.73m²) when compared to KTR with no Abs at 12 months. The significant difference in eGFR was observed since the 1st month PT. Multivariate analysis showed 4 factors independently and significantly associated with eGFR at 12mos PT: BPAR (-18.7 95%, CI -28.2 to -9.26, p‹0.001), AT₁Rab (-10.51, CI -20.9 to -0.095, p = 0.048), donor age (-0.42, CI -0.75 to -0.103 p = 0.010), and recipient age (-0.36, CI -0.67 to -0.048, p = 0.024). In this study AT₁Rab in pre-transplant sera from KTR, was an independent and significant risk factor contributing to a lower eGFR 12 months. PT. This finding deserves to be confirmed in a larger KTR population.

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