Skip to main content
Journal cover image

Pre-transplant Screening for Non-HLA Antibodies: Who should be Tested?

Publication ,  Journal Article
Philogene, MC; Zhou, S; Lonze, BE; Bagnasco, S; Alasfar, S; Montgomery, RA; Kraus, E; Jackson, AM; Leffell, MS; Zachary, AA
Published in: Hum Immunol
April 2018

Retrospective studies of angiotensin II type 1 receptor antibodies (AT1R-Ab) and anti-endothelial cell antibodies (AECA) have linked these antibodies to allograft injury. Because rising healthcare costs dictate judicious use of laboratory testing, we sought to define characteristics of kidney transplant recipients who may benefit from screening for non-HLA antibodies. Kidney recipients transplanted between 2011 and 2016 at Johns Hopkins, were evaluated for AT1R-Ab and AECA. Pre-transplant antibody levels were compared to clinical and biopsy indications of graft dysfunction. Biopsies were graded using the Banff' 2009-2013 criteria. AT1R-Ab and AECA were detected using ELISA and endothelial cell crossmatches, respectively. AT1R-Ab levels were higher in patients who were positive for AECAs. Re-transplanted patients (p < 0.0001), males (p = 0.008) and those with FSGS (p = 0.04) and younger (p = 0.04) at time of transplantation were more likely to be positive for AT1R-Ab prior to transplantation. Recipients who were positive for AT1R-Ab prior to transplantation had increases in serum creatinine within 3 months post-transplantation (p < 0.0001) and developed abnormal biopsies earlier than did AT1R-Ab negative patients (126 days versus 368 days respectively; p = 0.02). Defining a clinical protocol to identify and preemptively treat patients at risk for acute rejection with detectable non-HLA antibodies is an important objective for the transplant community.

Duke Scholars

Altmetric Attention Stats
Dimensions Citation Stats

Published In

Hum Immunol

DOI

EISSN

1879-1166

Publication Date

April 2018

Volume

79

Issue

4

Start / End Page

195 / 202

Location

United States

Related Subject Headings

  • Transplants
  • Transplantation, Homologous
  • Sex Factors
  • Retrospective Studies
  • Receptor, Angiotensin, Type 1
  • Preoperative Care
  • Patient Selection
  • Middle Aged
  • Male
  • Kidney Transplantation
 

Citation

APA
Chicago
ICMJE
MLA
NLM
Philogene, M. C., Zhou, S., Lonze, B. E., Bagnasco, S., Alasfar, S., Montgomery, R. A., … Zachary, A. A. (2018). Pre-transplant Screening for Non-HLA Antibodies: Who should be Tested? Hum Immunol, 79(4), 195–202. https://doi.org/10.1016/j.humimm.2018.02.001
Philogene, Mary Carmelle, Sheng Zhou, Bonnie E. Lonze, Serena Bagnasco, Sami Alasfar, Robert A. Montgomery, Edward Kraus, Annette M. Jackson, Mary S. Leffell, and Andrea A. Zachary. “Pre-transplant Screening for Non-HLA Antibodies: Who should be Tested?Hum Immunol 79, no. 4 (April 2018): 195–202. https://doi.org/10.1016/j.humimm.2018.02.001.
Philogene MC, Zhou S, Lonze BE, Bagnasco S, Alasfar S, Montgomery RA, et al. Pre-transplant Screening for Non-HLA Antibodies: Who should be Tested? Hum Immunol. 2018 Apr;79(4):195–202.
Philogene, Mary Carmelle, et al. “Pre-transplant Screening for Non-HLA Antibodies: Who should be Tested?Hum Immunol, vol. 79, no. 4, Apr. 2018, pp. 195–202. Pubmed, doi:10.1016/j.humimm.2018.02.001.
Philogene MC, Zhou S, Lonze BE, Bagnasco S, Alasfar S, Montgomery RA, Kraus E, Jackson AM, Leffell MS, Zachary AA. Pre-transplant Screening for Non-HLA Antibodies: Who should be Tested? Hum Immunol. 2018 Apr;79(4):195–202.
Journal cover image

Published In

Hum Immunol

DOI

EISSN

1879-1166

Publication Date

April 2018

Volume

79

Issue

4

Start / End Page

195 / 202

Location

United States

Related Subject Headings

  • Transplants
  • Transplantation, Homologous
  • Sex Factors
  • Retrospective Studies
  • Receptor, Angiotensin, Type 1
  • Preoperative Care
  • Patient Selection
  • Middle Aged
  • Male
  • Kidney Transplantation