Kidney Week

Abstract: SA-OR100

Lack of Association Between Pre-Transplant Donor-Specific Antibodies and Kidney Outcomes in Simultaneous Liver-Kidney Transplant Recipients

Session Information

• Transplantation: Approaches to Improve Post-Transplant Outcomes
  November 09, 2019 | Location: 151, Walter E. Washington Convention Center
  Abstract Time: 04:54 PM - 05:06 PM

Category: Transplantation

• 1902 Transplantation: Clinical

Authors

• Yazawa, Masahiko, University of Tennessee Health Science Center, Memphis, United States

Masahiko Yazawa, MD, PhD



Masahiko Yazawa, MD, PhD. 2005 April – 2007 March Junior resident, St. Marianna University School of Medicine, Kanagawa, Japan 2007 April－2009 March Senior resident, Department of Nephrology and Hypertension, St. Marianna University School of Medicine, Kanagawa, Japan 2009 April－2011 March Clinical Research with regard to kidney transplantation, Department of Nephrology and Hypertension, St. Marianna University School of Medicine, Kanagawa, Japan 2011 April－2011 September Assistant Professor and Nephrologist, Department of Nephrology and Hypertension, St. Marianna University School of Medicine, Kanagawa, Japan 2011 October－2012 September Nephrologist, Department of Nephrology, Chubu-Rosai Hospital, Nagoya, Japan 2012 October－2013 March Kidney transplant fellowship, Department of Transplant and Endocrine Surgery, Nagoya Daini Red Cross Hospital, Nagoya, Japan 2013 April－2014 March Assistant Professor and Nephrologist, Department of Nephrology and Hypertension, Kawasaki municipal hospital, Kanagawa, Japan 2014 April－ Assistant Professor and Nephrologist, Department of Nephrology and Hypertension, St. Marianna University School of Medicine, Kanagawa, Japan 2018 August－2020 March Post-doctoral fellow, Division of Transplant Surgery, Department of Surgery, The University of Tennessee Health Science Center, Memphis, TN, USA

• Cseprekál, Orsolya, Semmelweis University, Budapest, Hungary

Orsolya Cseprekál,

• Helmick, Ryan A., University of Tennessee Health Science Center, Memphis, Tennessee, United States

Ryan A. Helmick,

• Talwar, Manish, University of Tennessee Health Science Center, Memphis, Tennessee, United States

Manish Talwar,

• Balaraman, Vasanthi, University of Tennessee Health Science Center, Memphis, Tennessee, United States

Vasanthi Balaraman,

• Podila, Pradeep S b, Methodist Le Bonheur Healthcare, Memphis, Tennessee, United States

Pradeep S b Podila,

• Fossey, Sallyanne, DCI, Inc, Nashville, Tennessee, United States

Sallyanne Fossey,

• Agbim, Uchenna, University of Tennessee Health Science Center, Memphis, Tennessee, United States

Uchenna Agbim,

• Satapathy, Sanjaya K., Northshore University Hospital/Northwell Health, Manhasset, New York, United States

Sanjaya K. Satapathy,

• Sumida, Keiichi, University of Tennessee Health Science Center, Memphis, Tennessee, United States

Keiichi Sumida,

• Kovesdy, Csaba P., University of Tennessee Health Science Center, Memphis, Tennessee, United States

Csaba P. Kovesdy,

• Eason, James D., University of Tennessee Health Science Center, Memphis, Tennessee, United States

James D. Eason,

• Molnar, Miklos Zsolt, University of Tennessee Health Science Center, Memphis, Tennessee, United States

Miklos Zsolt Molnar,

Group or Team Name

• METEOR (MEthodist Transplant EpidemiOlogy Research) Group

Background

The impact of pre-transplant donor-specific antibodies (DSA), especially class II DSA, on kidney allograft outcomes remains unclear in simultaneous liver-kidney transplantation (SLKT) recipients.

Methods

We examined 85 recipients who underwent SLKT between 2009-2018 in our center. Associations between the presence of pre-transplant DSA [pre-transplant DSA (+)], including class of pre-transplant DSA ([Class I DSA (+)] and [Class II DSA (+)]), and worsening kidney function (WKF), composite kidney outcome (WKF or antibody-mediated rejection or death censored allograft kidney loss), death with functioning graft, and overall mortality were examined in unadjusted and age, sex, and race-adjusted Cox proportional hazards regression and competing risks regression models. WKF was defined as eGFR decrease of 30% or greater from baseline, or two or more episodes of proteinuria, at least 90 days apart from each other.

Results

The mean age at SLKT was 56 years old and 62% of the recipients were male. Nineteen recipients (22%) had pre-transplant DSA at the time of SLKT. For the WKF, the median follow-up time was 9.6 months. The incidence rate was 148/1,000 person-years in the DSA (+) group and 169/1,000 person-years in the DSA (-) group with a non-significant difference. Pre-transplant DSA (+) groups had similar risk of not only WKF (unadjusted model: HR=0.77, 95%CI: 0.29-2.05 and adjusted model: HR=0.36, 95%CI: 0.12-1.08) but also the other outcomes compared to DSA (-) group. We found similar results when comparing different DSA sub-classes with recipients without DSA.

Conclusion

Neither pre-formed DSA nor class II DSA was associated with worse kidney allograft outcomes or patient mortality in SLKT recipients.