Impact of pre-transplant anti-MICA sensitization in graft rejection and survival
Autor(a) principal: | |
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Data de Publicação: | 2015 |
Outros Autores: | , , , , , , , |
Tipo de documento: | Artigo |
Idioma: | eng |
Título da fonte: | Repositório Científico de Acesso Aberto de Portugal (Repositórios Cientìficos) |
Texto Completo: | http://hdl.handle.net/10400.16/1931 |
Resumo: | Background: Evidence supporting deleterious effect of preformed major histocompatibility class I chain-related A (MICA) antibodies in rejection incidence and graft survival is still unclear. Methods: Retrospective analysis of 554 kidney transplanted patients. Comparison between positive or negative for MICA antibodies patients was performed to characterize sensitizing triggers. Further classification according to pre-transplant flow cytometry-recorded anti–MICA and/or anti-human leukocyte antigen (HLA) antibodies was made to determine first year rejection incidence and graft survival. Multivariate analysis was applied to determine predictors for acute rejection. Results: Pre-formed anti-MICA antibodies were detected in 41 patients (7.4%). HLA sensitization, blood transfusions and pregnancies were frequently found in anti-MICA+ patients but only pre-formed anti-HLA class I antibodies showed independent association (OR 2.67, p= 0.02). Comparing to MICA-/HLA–, MICA-/HLA+ group presented significantly lower first year rejection-free survival (78.6% vs. 89.3%, p< 0.01), mostly occurred in the first six months, while no difference was found in MICA+/HLA– (88.9% vs. 89.3%, p= ns). MICA-/HLA+ showed independent impact in rejection (OR 2.09, p= 0.03), while no evidence was found in MICA+/HLA- (OR 1.08, p= ns). At 4 years, MICA-/HLA+ group presented lower graft survival (85.8% vs. 95.3%, p= 0.03). Again, no difference was found in MICA+/HLA- group (95.1% vs. 95.3%, p= ns). Conclusion: Our results do not support HLA-independent deleterious pathogenic role of pre-formed MICA antibodies on first year rejection incidence and graft survival. |
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Impact of pre-transplant anti-MICA sensitization in graft rejection and survivalImpacto da sensibilização anti -MICA pré -transplante na rejeição e sobrevida do enxertoHLAkidneyMICArejectionsurvivaltransplantrejeiçãorimsobrevidatransplanteBackground: Evidence supporting deleterious effect of preformed major histocompatibility class I chain-related A (MICA) antibodies in rejection incidence and graft survival is still unclear. Methods: Retrospective analysis of 554 kidney transplanted patients. Comparison between positive or negative for MICA antibodies patients was performed to characterize sensitizing triggers. Further classification according to pre-transplant flow cytometry-recorded anti–MICA and/or anti-human leukocyte antigen (HLA) antibodies was made to determine first year rejection incidence and graft survival. Multivariate analysis was applied to determine predictors for acute rejection. Results: Pre-formed anti-MICA antibodies were detected in 41 patients (7.4%). HLA sensitization, blood transfusions and pregnancies were frequently found in anti-MICA+ patients but only pre-formed anti-HLA class I antibodies showed independent association (OR 2.67, p= 0.02). Comparing to MICA-/HLA–, MICA-/HLA+ group presented significantly lower first year rejection-free survival (78.6% vs. 89.3%, p< 0.01), mostly occurred in the first six months, while no difference was found in MICA+/HLA– (88.9% vs. 89.3%, p= ns). MICA-/HLA+ showed independent impact in rejection (OR 2.09, p= 0.03), while no evidence was found in MICA+/HLA- (OR 1.08, p= ns). At 4 years, MICA-/HLA+ group presented lower graft survival (85.8% vs. 95.3%, p= 0.03). Again, no difference was found in MICA+/HLA- group (95.1% vs. 95.3%, p= ns). Conclusion: Our results do not support HLA-independent deleterious pathogenic role of pre-formed MICA antibodies on first year rejection incidence and graft survival.Introdução: O efeito deletério dos anticorpos para antigénios MICA (major histocompatibility class I chain-related A) na incidência de rejeição aguda e sobrevida do enxerto ainda não está consensualmente estabelecido. Metódos: Estudo retrospetivo de 554 transplantados renais. A análise comparativa entre doentes positivos e negativos para anticorpos anti-MICA pré-formados foi realizada para avaliar eventos sensibilizadores. A incidência de rejeição aguda no primeiro ano pós transplante renal e a sobrevida do enxerto renal foram determinadas consoante o resultado da citometria de fluxo pré-transplante para anticorpos anti-MICA e/ou anti- HLA (anti-human leukocyte antigen). Aplicou-se um modelo de análise multivariada para identificação de preditores independentes para rejeição aguda. Resultados: Foram identificados 41 doentes (7.4%) com anticorpos anti-MICA pré formados. A sensibilização para HLA, as transfusões sanguíneas e gestações prévias foram mais frequentes nos doentes MICA + mas apenas a presença de anticorpos anti-HLA classe I apresentou uma associação independente (OR 2.67, p= 0.02). Comparativamente ao grupo MICA-/HLA–, o grupo MICA-/HLA+ apresentou menor sobrevida livre de rejeição ao 1º ano (78.6% vs. 89.3%, p< 0.01), maioritariamente ocorrida nos primeiros seis meses, enquanto que nenhuma diferença foi encontrada com o grupo MICA+/HLA– (88.9% vs. 89.3%, p= ns). Apenas o status MICA-/HLA+ teve impacto independente na incidência de rejeição (OR 2.09, p= 0.03), ao contrário do status MICA+/HLA- (OR 1.08, p= ns). O grupo MICA-/HLA+ apresentou menor sobrevida do enxerto censurada para a morte aos 4 anos (85.8% vs. 95.3%, p= 0.03), não se verificando diferenças no grupo MICA+/HLA- (95.1% vs. 95.3%, p= ns). Conclusão: Os nossos resultados não suportam um efeito deletério dos anticorpos pré-formados para MICA, independente da sensibilização HLA, na incidência de rejeição aguda no 1º ano pós transplante e na sobrevida do enxerto.Repositório Científico do Centro Hospitalar Universitário de Santo AntónioCosta, R.Malheiro, J.Tafulo, S.Santos, C.Almeida, M.Pedroso, S.Martins, L.Dias, L.Castro-Henriques, A.2016-04-26T16:15:36Z20152015-01-01T00:00:00Zinfo:eu-repo/semantics/publishedVersioninfo:eu-repo/semantics/articleapplication/pdfhttp://hdl.handle.net/10400.16/1931engPort J Nephrol Hypert 2015; 29(2): 130-1382183-1289info:eu-repo/semantics/openAccessreponame:Repositório Científico de Acesso Aberto de Portugal (Repositórios Cientìficos)instname:Agência para a Sociedade do Conhecimento (UMIC) - FCT - Sociedade da Informaçãoinstacron:RCAAP2023-10-20T10:58:13Zoai:repositorio.chporto.pt:10400.16/1931Portal AgregadorONGhttps://www.rcaap.pt/oai/openaireopendoar:71602024-03-19T20:38:14.664082Repositório Científico de Acesso Aberto de Portugal (Repositórios Cientìficos) - Agência para a Sociedade do Conhecimento (UMIC) - FCT - Sociedade da Informaçãofalse |
dc.title.none.fl_str_mv |
Impact of pre-transplant anti-MICA sensitization in graft rejection and survival Impacto da sensibilização anti -MICA pré -transplante na rejeição e sobrevida do enxerto |
title |
Impact of pre-transplant anti-MICA sensitization in graft rejection and survival |
spellingShingle |
Impact of pre-transplant anti-MICA sensitization in graft rejection and survival Costa, R. HLA kidney MICA rejection survival transplant rejeição rim sobrevida transplante |
title_short |
Impact of pre-transplant anti-MICA sensitization in graft rejection and survival |
title_full |
Impact of pre-transplant anti-MICA sensitization in graft rejection and survival |
title_fullStr |
Impact of pre-transplant anti-MICA sensitization in graft rejection and survival |
title_full_unstemmed |
Impact of pre-transplant anti-MICA sensitization in graft rejection and survival |
title_sort |
Impact of pre-transplant anti-MICA sensitization in graft rejection and survival |
author |
Costa, R. |
author_facet |
Costa, R. Malheiro, J. Tafulo, S. Santos, C. Almeida, M. Pedroso, S. Martins, L. Dias, L. Castro-Henriques, A. |
author_role |
author |
author2 |
Malheiro, J. Tafulo, S. Santos, C. Almeida, M. Pedroso, S. Martins, L. Dias, L. Castro-Henriques, A. |
author2_role |
author author author author author author author author |
dc.contributor.none.fl_str_mv |
Repositório Científico do Centro Hospitalar Universitário de Santo António |
dc.contributor.author.fl_str_mv |
Costa, R. Malheiro, J. Tafulo, S. Santos, C. Almeida, M. Pedroso, S. Martins, L. Dias, L. Castro-Henriques, A. |
dc.subject.por.fl_str_mv |
HLA kidney MICA rejection survival transplant rejeição rim sobrevida transplante |
topic |
HLA kidney MICA rejection survival transplant rejeição rim sobrevida transplante |
description |
Background: Evidence supporting deleterious effect of preformed major histocompatibility class I chain-related A (MICA) antibodies in rejection incidence and graft survival is still unclear. Methods: Retrospective analysis of 554 kidney transplanted patients. Comparison between positive or negative for MICA antibodies patients was performed to characterize sensitizing triggers. Further classification according to pre-transplant flow cytometry-recorded anti–MICA and/or anti-human leukocyte antigen (HLA) antibodies was made to determine first year rejection incidence and graft survival. Multivariate analysis was applied to determine predictors for acute rejection. Results: Pre-formed anti-MICA antibodies were detected in 41 patients (7.4%). HLA sensitization, blood transfusions and pregnancies were frequently found in anti-MICA+ patients but only pre-formed anti-HLA class I antibodies showed independent association (OR 2.67, p= 0.02). Comparing to MICA-/HLA–, MICA-/HLA+ group presented significantly lower first year rejection-free survival (78.6% vs. 89.3%, p< 0.01), mostly occurred in the first six months, while no difference was found in MICA+/HLA– (88.9% vs. 89.3%, p= ns). MICA-/HLA+ showed independent impact in rejection (OR 2.09, p= 0.03), while no evidence was found in MICA+/HLA- (OR 1.08, p= ns). At 4 years, MICA-/HLA+ group presented lower graft survival (85.8% vs. 95.3%, p= 0.03). Again, no difference was found in MICA+/HLA- group (95.1% vs. 95.3%, p= ns). Conclusion: Our results do not support HLA-independent deleterious pathogenic role of pre-formed MICA antibodies on first year rejection incidence and graft survival. |
publishDate |
2015 |
dc.date.none.fl_str_mv |
2015 2015-01-01T00:00:00Z 2016-04-26T16:15:36Z |
dc.type.status.fl_str_mv |
info:eu-repo/semantics/publishedVersion |
dc.type.driver.fl_str_mv |
info:eu-repo/semantics/article |
format |
article |
status_str |
publishedVersion |
dc.identifier.uri.fl_str_mv |
http://hdl.handle.net/10400.16/1931 |
url |
http://hdl.handle.net/10400.16/1931 |
dc.language.iso.fl_str_mv |
eng |
language |
eng |
dc.relation.none.fl_str_mv |
Port J Nephrol Hypert 2015; 29(2): 130-138 2183-1289 |
dc.rights.driver.fl_str_mv |
info:eu-repo/semantics/openAccess |
eu_rights_str_mv |
openAccess |
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application/pdf |
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reponame:Repositório Científico de Acesso Aberto de Portugal (Repositórios Cientìficos) instname:Agência para a Sociedade do Conhecimento (UMIC) - FCT - Sociedade da Informação instacron:RCAAP |
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Agência para a Sociedade do Conhecimento (UMIC) - FCT - Sociedade da Informação |
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RCAAP |
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RCAAP |
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Repositório Científico de Acesso Aberto de Portugal (Repositórios Cientìficos) |
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Repositório Científico de Acesso Aberto de Portugal (Repositórios Cientìficos) |
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Repositório Científico de Acesso Aberto de Portugal (Repositórios Cientìficos) - Agência para a Sociedade do Conhecimento (UMIC) - FCT - Sociedade da Informação |
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