Estamos realizando la búsqueda. Por favor, espere...
Abstract: Conversion of kidney-transplant recipients from calcineurin inhibitors to mTOR
inhibitors has been suggested to be a risk factor for increased alloimmune
response. We have analyzed the development of new HLA-antibodies (HLA-Abs)
early after conversion in 184 patients converted in stable phase at our hospital
and compared with a control group of nonconverted comparable 63 transplants.
Using single-antigen solid-phase immunoassay analysis, a preconversion and a
3–6 months postconversion sera were prospectively analyzed in every patient for
the appearance of new HLA-Abs. Renal function at 2 years postconversion and
cumulative graft survival were compared between groups. In 16 patients, new
HLA-Abs (3-DSA and 13-NonDSA), not present at the moment of conversion,
were detected (8.7% vs. 3.1% in the control group). The type of mTORi used,
type of CNI preconversion, the presence of steroids, time of conversion, or indication
for conversion did not have influence on this effect but the presence of HLAAbs
before conversion highly correlated with the appearance of new specificities.
Patients with de novo HLA-Abs showed a trend to worst graft function and
survival. In conclusion, conversion to mTORi can be followed by early appearance
of de novo HLA-Abs, especially in patients with HLA-Abs preconversion,
and this complication should be screened early after conversion.
Fuente: Transpl Int. 2014 Aug;27(8):847-56
Editorial: Blackwell Publishing Ltd
Fecha de publicación: 01/08/2014
Nº de páginas: 10
Tipo de publicación: Artículo de Revista
JUAN CARLOS RUIZ SAN MILLAN
MARCOS LOPEZ HOYOS
DAVID SAN SEGUNDO ARRIBAS
ESTRELLA QUINTELA OBREGON
EMILIO RODRIGO CALABIA
CARLOS GOMEZ ALAMILLO
IÑIGO ROMON ALONSO
MANUEL ANTONIO ARIAS RODRIGUEZ