Clinical outcomes among renal transplant recipients with pre-transplant weakly reactive donor-specific antibodies.

BACKGROUND

Alloantibody can lead to antibody-mediated rejection and graft loss in renal transplantation, necessitating an assessment of cross-match compatibility. Within the past decade, more specific solid phase assays of alloantibody have been widely adopted, allowing virtual cross-matching based on unacceptable antigens, the threshold of which is determined by individual centers.

METHODS

We examined the clinical outcomes of 482 patients transplanted 2007-2009 in a single center, focusing on 30 patients with weakly reactive donor-specific antibody (DSA) determined prospectively prior to renal transplant.

RESULTS

Compared with patients without DSA, patients with weakly reactive DSA do not have increased rates of antibody-mediated rejection, cellular rejection, or graft loss despite conventional immunosuppression utilization.

CONCLUSIONS

Using the screening methodology and immunosuppression regimen, we have applied to the patients with weak DSA allows them to be transplanted with equivalent outcomes as those without DSA, despite the overall higher risk characteristics of the patients in the weak DSA group.