FRINK Linked Data Fragments server

Matches in SemOpenAlex for { <https://semopenalex.org/work/W2331725906> ?p ?o ?g. }

• W2331725906 endingPage "1076" @default.
• W2331725906 startingPage "1076" @default.
• W2331725906 abstract "Introduction: Screening for HLA-specific antibodies (Ab) is routine for patients on kidney transplant waiting lists. In the UK screening is performed at least every 3 months, and HLA antigens to which a patient has detectable Ab are listed as ‘unacceptable mismatches’. Many units use a stringent definition of unacceptable, for example any HLA antigen to which Ab can be detected with an MFI >1000 (using the Luminex® platform). Whilst this approach is effective in preventing a positive crossmatch (XM) following allocation, it also precludes the offer of organs to sensitized patients. Here we describe our experience of deceased donor (DD) renal transplantation knowingly performed in the presence of donor-specific anti-HLA Ab (DSA). Methods: 21 patients received HLA Ab-incompatible (HLAi) DD transplants in one of two circumstances: (1) Patients in whom the threshold for ‘unacceptable’ for any HLA specificity was increased to a Luminex MFI >3000 (n=8), and (2) Patients with a positive flow cytometry B-cell crossmatch (FC-BXM) known to have anti-HLA-DP Ab (n=13). Since donors in the UK are not routinely DP genotyped, the presence of DP DSA was assumed, and confirmed retrospectively by donor DP genotyping. Complement-dependent cytotoxicity crossmatch (CDC-XM) using a recent pre-transplant serum sample was negative in all patients. FC-BXM was positive in 15 (71%). The mean DSA MFI was 5268 (range 1086-16356) and mean follow-up length was 20.8 months (range 1-64). All episodes of antibody-mediated rejection (AMR) and T cell-mediated rejection (TCMR) were analyzed. Results: All patients received tacrolimus, MMF and prednisolone. Induction agents used were Basiliximab (n=8), Alemtuzumab (n=9) and Thymoglobulin (n=4). No planned Ab removal was used. Death-censored 1 year graft survival was 92% (12/13 patients with >12 months follow up). Acute rejection (AR) was significantly more common in those receiving basiliximab at induction compared to a T-cell depleting agent (75% (6/8: 3 with TCMR and 3 with AMR) versus 15% (2/13: both AMR) respectively, p=0.018). Patients developing AMR were more likely to have a positive CDC-XM using historic serum (3/5 with AMR versus 1/16 without AMR, p=0.028). Of the 12 patients with isolated DP DSA, 2 experienced AMR and 2 TCMR. All episodes of AMR were reversed with plasma exchange. Mean creatinine for those patients with graft function at baseline (18/21) was 137μmol/L and at 1 year was 133μmol/L (n=12). There were 3 deaths (post-operative haemorrhage at 2 weeks, disseminated aspergillosis at 3 weeks and a cerebral lymphoma at 4 years) and 1 graft loss (graft rupture with Banff 2B AR at 1 week). Conclusions: HLAi DD renal transplantation is associated with a high incidence of AR, with AMR in 24% of patients despite negative CDC-XM. Our limited experience suggests that: (1) T-cell depleting induction is beneficial, (2) A current negative but historic positive CDC-XM could prompt prospective antibody removal and (3) donor HLA-DP genotyping should be routine practice. Despite high rates of AR, transplantation in these high-risk recipients is still achievable with satisfactory allograft function at up to 5 years post-transplant." @default.
• W2331725906 created "2016-06-24" @default.
• W2331725906 creator A5004574736 @default.
• W2331725906 creator A5005294015 @default.
• W2331725906 creator A5036117738 @default.
• W2331725906 creator A5037344946 @default.
• W2331725906 creator A5043820439 @default.
• W2331725906 creator A5081763092 @default.
• W2331725906 creator A5082524136 @default.
• W2331725906 date "2012-11-01" @default.
• W2331725906 modified "2023-09-27" @default.
• W2331725906 title "Deceased Donor HLA Antibody Incompatible Renal Transplantation without Antibody Removal: High Incidence of Acute Rejection Reduced by T-Cell Depleting Induction Therapy" @default.
• W2331725906 doi "https://doi.org/10.1097/00007890-201211271-02133" @default.
• W2331725906 hasPublicationYear "2012" @default.
• W2331725906 type Work @default.
• W2331725906 sameAs 2331725906 @default.
• W2331725906 citedByCount "0" @default.
• W2331725906 crossrefType "journal-article" @default.
• W2331725906 hasAuthorship W2331725906A5004574736 @default.
• W2331725906 hasAuthorship W2331725906A5005294015 @default.
• W2331725906 hasAuthorship W2331725906A5036117738 @default.
• W2331725906 hasAuthorship W2331725906A5037344946 @default.
• W2331725906 hasAuthorship W2331725906A5043820439 @default.
• W2331725906 hasAuthorship W2331725906A5081763092 @default.
• W2331725906 hasAuthorship W2331725906A5082524136 @default.
• W2331725906 hasBestOaLocation W23317259061 @default.
• W2331725906 hasConcept C120665830 @default.
• W2331725906 hasConcept C121332964 @default.
• W2331725906 hasConcept C126322002 @default.
• W2331725906 hasConcept C147483822 @default.
• W2331725906 hasConcept C159654299 @default.
• W2331725906 hasConcept C188280979 @default.
• W2331725906 hasConcept C202965653 @default.
• W2331725906 hasConcept C203014093 @default.
• W2331725906 hasConcept C2777726029 @default.
• W2331725906 hasConcept C2780303639 @default.
• W2331725906 hasConcept C2909478873 @default.
• W2331725906 hasConcept C2911091166 @default.
• W2331725906 hasConcept C3019514911 @default.
• W2331725906 hasConcept C40677261 @default.
• W2331725906 hasConcept C542903549 @default.
• W2331725906 hasConcept C553184892 @default.
• W2331725906 hasConcept C61511704 @default.
• W2331725906 hasConcept C71924100 @default.
• W2331725906 hasConcept C90924648 @default.
• W2331725906 hasConceptScore W2331725906C120665830 @default.
• W2331725906 hasConceptScore W2331725906C121332964 @default.
• W2331725906 hasConceptScore W2331725906C126322002 @default.
• W2331725906 hasConceptScore W2331725906C147483822 @default.
• W2331725906 hasConceptScore W2331725906C159654299 @default.
• W2331725906 hasConceptScore W2331725906C188280979 @default.
• W2331725906 hasConceptScore W2331725906C202965653 @default.
• W2331725906 hasConceptScore W2331725906C203014093 @default.
• W2331725906 hasConceptScore W2331725906C2777726029 @default.
• W2331725906 hasConceptScore W2331725906C2780303639 @default.
• W2331725906 hasConceptScore W2331725906C2909478873 @default.
• W2331725906 hasConceptScore W2331725906C2911091166 @default.
• W2331725906 hasConceptScore W2331725906C3019514911 @default.
• W2331725906 hasConceptScore W2331725906C40677261 @default.
• W2331725906 hasConceptScore W2331725906C542903549 @default.
• W2331725906 hasConceptScore W2331725906C553184892 @default.
• W2331725906 hasConceptScore W2331725906C61511704 @default.
• W2331725906 hasConceptScore W2331725906C71924100 @default.
• W2331725906 hasConceptScore W2331725906C90924648 @default.
• W2331725906 hasIssue "10S" @default.
• W2331725906 hasLocation W23317259061 @default.
• W2331725906 hasOpenAccess W2331725906 @default.
• W2331725906 hasPrimaryLocation W23317259061 @default.
• W2331725906 hasRelatedWork W1564380435 @default.
• W2331725906 hasRelatedWork W1901800727 @default.
• W2331725906 hasRelatedWork W2019101100 @default.
• W2331725906 hasRelatedWork W2027826350 @default.
• W2331725906 hasRelatedWork W2028822437 @default.
• W2331725906 hasRelatedWork W2063207847 @default.
• W2331725906 hasRelatedWork W2120149311 @default.
• W2331725906 hasRelatedWork W2391681134 @default.
• W2331725906 hasRelatedWork W2992668836 @default.
• W2331725906 hasRelatedWork W3031585746 @default.
• W2331725906 hasVolume "94" @default.
• W2331725906 isParatext "false" @default.
• W2331725906 isRetracted "false" @default.
• W2331725906 magId "2331725906" @default.
• W2331725906 workType "article" @default.