Premium
Evolution of donor‐specific antibodies ( DSA ) and incidence of de novo DSA in solid organ transplant recipients after switch to everolimus alone or associated with low dose of calcineurin inhibitors
Author(s) -
Perbos Emma,
Juinier Estelle,
Guidicelli Gwendaline,
Dromer Claire,
Merville Pierre,
Billes MarcAlain,
Taupin JeanLuc,
NeauCransac Martine
Publication year - 2014
Publication title -
clinical transplantation
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.918
H-Index - 76
eISSN - 1399-0012
pISSN - 0902-0063
DOI - 10.1111/ctr.12418
Subject(s) - medicine , everolimus , calcineurin , donor specific antibodies , incidence (geometry) , antibody , transplantation , isoantibodies , urology , kidney , kidney transplantation , immunosuppression , heart transplantation , tacrolimus , gastroenterology , immunology , optics , physics
Background Everolimus ( EVR ) is used in organ transplantation to minimize calcineurin inhibitors ( CNI ). Some studies pointed out an increase in rejection and de novo donor‐specific antibodies ( DSA ) incidence in kidney transplant patients after switch to EVR and CNI withdrawal. The aims of our study were to determine the evolution of anti‐ HLA antibodies and the incidence of de novo DSA in transplant recipients after conversion to EVR . Methods Heart, lung, kidney, and liver transplant recipients were included in a retrospective, monocentric case–control study. Anti‐ HLA antibodies were identified at transplantation, pre‐switch, and at three, six, and 12 months post‐switch. Results Conversion to EVR was performed about six yr after the transplant, and low‐dose CNI was maintained in 60% of patients. We found no statistical difference for rejection, evolution of preformed anti‐ HLA antibodies or de novo DSA , after conversion to EVR or not. Incidence of anti‐class II DSA tended to increase at month 12 whatever the immunosuppressive regimen. Conclusions Late conversion to EVR appears to be safe and to not modify the natural evolution of anti‐ HLA antibodies in organ transplantation. As 60% of patients received EVR and low doses of CNI , it seems that such combinations could be used with a good outcome.