Trial reportJournal of the American Society of Nephrology : JASN2013
The clinical impact of humoral immunity in pediatric renal transplantation.
Trial report in Journal of the American Society of Nephrology : JASN, 2013. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 23 papers, 1 of them a synthesis that pooled it.
What it found
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The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.
Who cites it
23 citing papers in PubMed, 1 synthesis or guideline pooled it, 60 citations in OpenAlex.
- Steroid avoidance or withdrawal for kidney transplant recipients.The Cochrane database of systematic reviews · 2016Pooled it
- Incidence, risk factors, management strategies, and outcomes of antibody-mediated rejection in pediatric kidney transplant recipients-a multicenter analysis of the Cooperative European Paediatric Renal Transplant Initiative (CERTAIN).Pediatric nephrology (Berlin, Germany) · 2025Article
- Clinical Outcome of Kidney Transplant Recipients with C1q-Binding De Novo Donor Specific Antibodies: A Single-Center Experience.Journal of clinical medicine · 2023Article
- Long term tolerability and clinical outcomes associated with tocilizumab in the treatment of refractory antibody mediated rejection (AMR) in pediatric renal transplant recipients.Clinical transplantation · 2022Article
- Outcomes of paediatric kidney transplant recipients using the updated 2013/2017 Banff histopathological classification for antibody-mediated rejection.Pediatric nephrology (Berlin, Germany) · 2021Article
- Association of non-HLA antibodies against endothelial targets and donor-specific HLA antibodies with antibody-mediated rejection and graft function in pediatric kidney transplant recipients.Pediatric nephrology (Berlin, Germany) · 2021Article
- Kidney re-transplantation in a child across the barrier of persisting angiotensin II type I receptor antibodies.Pediatric nephrology (Berlin, Germany) · 2021Article
- Characterizing pre-transplant and post-transplant kidney rejection risk by B cell immune repertoire sequencing.Nature communications · 2019Article
- Biomarkers to detect rejection after kidney transplantation.Pediatric nephrology (Berlin, Germany) · 2018Review
- Persistent C4d and antibody-mediated rejection in pediatric renal transplant patients.Pediatric transplantation · 2017Article
- Application and interpretation of histocompatibility data in pediatric kidney transplantation.Current opinion in organ transplantation · 2017Review
- Relationship Among Viremia/Viral Infection, Alloimmunity, and Nutritional Parameters in the First Year After Pediatric Kidney Transplantation.American journal of transplantation : official journal of the American Society of Transplantation and the American Society of Transplant Surgeons · 2017Observational
- MICA and NKG2D: Is There an Impact on Kidney Transplant Outcome?Frontiers in immunology · 2017Review
- Bortezomib may stabilize pediatric renal transplant recipients with antibody-mediated rejection.Pediatric nephrology (Berlin, Germany) · 2016Article
- Association of C1q-fixing DSA with late graft failure in pediatric renal transplant recipients.Pediatric nephrology (Berlin, Germany) · 2016Article
- Antibody-mediated rejection in pediatric kidney transplantation: pathophysiology, diagnosis, and management.Drugs · 2015Review
- Acute and chronic antibody-mediated rejection in pediatric kidney transplantation.Pediatric nephrology (Berlin, Germany) · 2015Review
- Antibody-mediated rejection in young kidney transplant recipients: the dilemma of noncompliance and insufficient immunosuppression.Pediatric nephrology (Berlin, Germany) · 2015Article
- Racial and ethnic disparities in pediatric renal allograft survival in the United States.Kidney international · 2015Article
- Computational Models for Transplant Biomarker Discovery.Frontiers in immunology · 2015Review
Corrections and comments
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Authors and funding
24 authors at 14 institutions in 2 countries.
Funding
Abstract
The development of anti-donor humoral responses after transplantation associates with higher risks for acute rejection and 1-year graft survival in adults, but the influence of humoral immunity on transplant outcomes in children is not well understood. Here, we studied the evolution of humoral immunity in low-risk pediatric patients during the first 2 years after renal transplantation. Using data from 130 pediatric renal transplant patients randomized to steroid-free (SF) or steroid-based (SB) immunosuppression in the NIH-SNSO1 trial, we correlated the presence of serum anti-HLA antibodies to donor HLA antigens (donor-specific antibodies) and serum MHC class 1-related chain A (MICA) antibody with both clinical outcomes and histology identified on protocol biopsies at 0, 6, 12, and 24 months. We detected de novo antibodies after transplant in 24% (23% of SF group and 25% of SB group), most often after the first year. Overall, 22% developed anti-HLA antibodies, of which 6% were donor-specific antibodies, and 6% developed anti-MICA antibody. Presence of these antibodies de novo associated with significantly higher risks for acute rejection (P=0.02), chronic graft injury (P=0.02), and decline in graft function (P=0.02). In summary, antibodies to HLA and MICA antigens appear in approximately 25% of unsensitized pediatric patients, placing them at greater risk for acute and chronic rejection with accelerated loss of graft function. Avoiding steroids does not seem to modify this incidence. Whether serial assessments of these antibodies after transplant could guide individual tailoring of immunosuppression requires additional study.
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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.