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Pediatric kidney recipients may benefit from monitoring for donor‐specific antibodies
Author(s) -
Athavale Deepa,
Worthington Judith,
Webb Nicholas J. A.,
Roberts Denise,
Martin Susan,
Shenoy Mohan
Publication year - 2014
Publication title -
pediatric transplantation
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.457
H-Index - 69
eISSN - 1399-3046
pISSN - 1397-3142
DOI - 10.1111/petr.12247
Subject(s) - medicine , donor specific antibodies , cohort , prospective cohort study , kidney transplantation , transplantation , kidney , urology , surgery
There are limited data regarding the presence of DSA s and their effect on graft function in pediatric renal transplantation. The role for serial DSA monitoring in routine clinical practice is unclear. All patients attending a regional transplant clinic were tested for DSA s, measured using Luminex single/mixed antigen beads. Any patient having a positive result subsequently underwent historic testing on samples previously obtained. DSA ‐positive patients underwent prospective monitoring of DSA s, and correlation with clinical events was studied. Nine of a total of 50 patients (18%) were DSA ‐positive, of whom six had graft dysfunction. The DSA ‐positive cohort had significantly increased episodes of AR (p = 0.01). There were two graft losses in the DSA ‐positive group and none in the DSA ‐negative group. Eight of the DSA ‐positive group had potentially reduced exposure to IS because of either adherence issues or clinical indications. DSA s were associated with increased risk of rejection. There appears to be a role for serial monitoring of DSA s in patients where there has been a reduced exposure to IS so that early intervention with optimized IS can be considered.