التفاصيل البيبلوغرافية
| العنوان: |
Impact of DSA and immunosuppression minimization on rejection, graft, and patient survival after simultaneous liver–kidney transplantation |
| المؤلفون: |
Dekeyser, Manon, Taupin, Jean-Luc, Elias, Michelle, Ichaï, Philippe, Herr, Florence, Boudon, Marc, Brunel, Melanie, Sa cunha, Antonio, Coilly, Audrey, Saliba, Faouzi, Durrbach, Antoine |
| المصدر: |
Frontiers in Medicine ; volume 9 ; ISSN 2296-858X |
| بيانات النشر: |
Frontiers Media SA |
| سنة النشر: |
2022 |
| المجموعة: |
Frontiers (Publisher - via CrossRef) |
| مصطلحات موضوعية: |
General Medicine |
| الوصف: |
Background Acute rejection rate is low after simultaneous liver–kidney transplantation (SLKT), leading some groups to minimize immunosuppressive (IS) regimens. However, the impact of preformed (pDSA) or de novo donor-specific antibodies (dnDSA) on the graft remains unclear. Methods We performed a retrospective analysis of 102 consecutive SLKT patients to study the impact of anti-HLA antibodies. Results Anti-HLA antibodies were detected in 75 recipients (class I 23.8%, both classes I and II 23.8%, and class II 14.3%). In total, 42.8% of the patients had pDSA and 21.7% developed dnDSA. Overall patient survival at 1–3 and 5 years, was respectively 88, 84, and 80%. Acute rejection occurred respectively in 3 (2.9%) liver and 6 kidney (5.9%) recipients. pDSA with titers over 10,000 mean fluorescence intensity (14.3%) was associated with lower patient survival (40 vs. 82%) but not with acute rejection. In a multivariable Cox regression analysis, the risk of death was associated with maleness, the highest titer of pDSA ( p < 0.0007) or the sum of pDSA >10,000. Renal function did not differ between patients with class I pDSA ( p = 0.631) and those with class II pDSA ( p = 0.112) or between patients with and without a positive cross-match ( p = 0.842). dnDSA were not associated with acute rejection, graft dysfunction or patient survival. IS minimization was not associated with rejection, graft dysfunction or death. Conclusion In SLKT, high levels of pDSA >10,000 were associated with lower patient survival, but not rejection or graft survival. Minimization of maintenance immunosuppression regimen was not associated with a poorer outcome. |
| نوع الوثيقة: |
article in journal/newspaper |
| اللغة: |
unknown |
| DOI: |
10.3389/fmed.2022.949833 |
| DOI: |
10.3389/fmed.2022.949833/full |
| الإتاحة: |
https://doi.org/10.3389/fmed.2022.949833Test |
| حقوق: |
https://creativecommons.org/licenses/by/4.0Test/ |
| رقم الانضمام: |
edsbas.5437EB85 |
| قاعدة البيانات: |
BASE |
