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논문분류	춘계학술대회 초록집
제목	Development of De Novo Anti-HLA Antibodies in Kidney Transplant Recipients
저자	Ho Sik Shin1, Guleria I2, Ikle D3, Vincenti F4, Morrison Y5, Nickerson P6, Bridges N5, Harmon W7, Sayegh MH2
출판정보	2018; 2018(1):
키워드	Alloantibody \| Kidney Transplant \| Pediatric \| Induction Therapy
초록	Objectives: The risk factors associated with the development of post-transplant de novo anti-HLA antibodies in unsensitized kidney transplant recipients remain inadequately characterized. The Clinical Trials in Organ Transplantation CTOT-02/CCTPT-02 study was a prospective multicenter clinical trial designed to identify subjects who developed de novo anti-HLA antibodies following kidney transplantation. Methods: Unsensitized subjects were enrolled after kidney transplantation and monitored at 3-month intervals for antibody development for at least two years and as long as 5 years. Results: Among 653 subjects from 18 centers ranging in age from 3 to 70 (median age, 45) years, 79 subjects (12%) developed at least one de novo anti-HLA antibody. Multivariate analysis indicated that pediatric subjects were significantly more likely to develop anti-HLA antibodies compared with subjects >18 years old. On the other hand, use of anti-IL-2R antibody induction therapy was protective against anti-HLA antibody development. The presence of in vitro complement (C1q) binding antibody was associated with rejection (OR=4.80 (1.39-16.59), p=0.013). Conclusions: In a low risk kidney transplant population, the risk of developing anti-HLA antibodies was greater in children <18 years of age compared with adults, and greatest in young children (<12 years). Induction with an anti-IL-2R antibody was protective against the development of anti-HLA antibodies regardless of age.
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