Rates and Determinants of Progression to Graft Failure in Kidney Allograft Recipients With De Novo Donor‐Specific Antibody

Understanding rates and determinants of clinical pathologic progression for recipients with de novo donor‐specific antibody (dnDSA), especially subclinical dnDSA, may identify surrogate endpoints and inform clinical trial design. A consecutive cohort of 508 renal transplant recipients (n = 64 with d...

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Bibliographic Details
Published in:American journal of transplantation 2015-11, Vol.15 (11), p.2921-2930
Main Authors: Wiebe, C., Gibson, I. W., Blydt‐Hansen, T. D., Pochinco, D., Birk, P. E., Ho, J., Karpinski, M., Goldberg, A., Storsley, L., Rush, D. N., Nickerson, P. W.
Format: Article
Language:English
Subjects:
Acute Disease
Adult
Age Factors
Alloantibody
Allografts - immunology
Child
Child, Preschool
Chronic Disease
Clinical trials
Cohort Studies
compliance/adherence
Delayed Graft Function - immunology
Disease Progression
Follow-Up Studies
Graft Rejection - immunology
Graft Rejection - pathology
Health risk assessment
Humans
Isoantibodies - analysis
Isoantibodies - immunology
Kaplan-Meier Estimate
Kidney Transplantation - adverse effects
Kidney Transplantation - methods
Male
Middle Aged
Multivariate Analysis
Predictive Value of Tests
Proportional Hazards Models
rejection: antibody‐mediated (ABMR)
rejection: chronic
rejection: T cell–mediated (TCMR)
Retrospective Studies
Risk Assessment
Sex Factors
Statistics, Nonparametric
T-Lymphocytes, Regulatory - immunology
Time Factors
Transplant Recipients
Treatment Outcome
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Summary:Understanding rates and determinants of clinical pathologic progression for recipients with de novo donor‐specific antibody (dnDSA), especially subclinical dnDSA, may identify surrogate endpoints and inform clinical trial design. A consecutive cohort of 508 renal transplant recipients (n = 64 with dnDSA) was studied. Recipients (n = 388) without dnDSA or dysfunction had an eGFR decline of −0.65 mL/min/1.73 m2/year. In recipients with dnDSA, the rate eGFR decline was significantly increased prior to dnDSA onset (−2.89 vs. −0.65 mL/min/1.73 m2/year, p 
ISSN:1600-6135
1600-6143
DOI:10.1111/ajt.13347