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Results of early treatment for de novo donor‐specific antibodies in pediatric kidney transplant recipients in a cross‐sectional and longitudinal cohort
Author(s) -
Charnaya Olga,
Tuchman Shamir,
Moudgil Asha
Publication year - 2018
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.13108
Subject(s) - medicine , renal function , tacrolimus , urology , cohort , kidney , kidney transplant , kidney transplantation , risk factor , transplantation , surgery , gastroenterology
Abstract The development of dn DSA anti‐ HLA antibodies has been shown to be a significant risk factor for graft failure. In 2008, we instituted a routine protocol of standardized monitoring and treatment of dn DSA in pediatric kidney transplant recipients. Of 67 first‐time pediatric kidney transplant recipients, 26 (38%) developed dn DSA after 1.36 ( IQ 1‐2.14) years. Coefficient of variance of tacrolimus, a surrogate marker of non‐adherence, was found to be the single most important risk factor for dn DSA development. Overall, there was a significant reduction in dn DSA with treatment in 19 (76%) children. No difference in graft survival and estimated glomerular filtration rate was noted between dn DSA negative and those treated for dn DSA . There was an increased risk of hospitalization in those treated for dn DSA . This study suggests that early detection and treatment of dn DSA can help to prevent graft failure and preserve graft function in the short term. Future studies and longer follow‐up are needed to fully elucidate the effect of early detection and treatment of dn DSA in pediatric kidney transplant recipients.