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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

Category: Transplantation

  • 1902 Transplantation: Clinical

Authors

  • Yazawa, Masahiko, University of Tennessee Health Science Center, Memphis, United States
  • Cseprekál, Orsolya, Semmelweis University, Budapest, Hungary
  • Helmick, Ryan A., University of Tennessee Health Science Center, Memphis, Tennessee, United States
  • Talwar, Manish, University of Tennessee Health Science Center, Memphis, Tennessee, United States
  • Balaraman, Vasanthi, University of Tennessee Health Science Center, Memphis, Tennessee, United States
  • Podila, Pradeep S b, Methodist Le Bonheur Healthcare, Memphis, Tennessee, United States
  • Fossey, Sallyanne, DCI, Inc, Nashville, Tennessee, United States
  • Agbim, Uchenna, University of Tennessee Health Science Center, Memphis, Tennessee, United States
  • Satapathy, Sanjaya K., Northshore University Hospital/Northwell Health, Manhasset, New York, United States
  • Sumida, Keiichi, University of Tennessee Health Science Center, Memphis, Tennessee, United States
  • Kovesdy, Csaba P., University of Tennessee Health Science Center, Memphis, Tennessee, United States
  • Eason, James D., University of Tennessee Health Science Center, Memphis, Tennessee, United States
  • Molnar, Miklos Zsolt, University of Tennessee Health Science Center, Memphis, Tennessee, United States

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.