ArticlePediatric nephrology (Berlin, Germany)2016
Association of C1q-fixing DSA with late graft failure in pediatric renal transplant recipients.
Article in Pediatric nephrology (Berlin, Germany), 2016. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 20 papers, 3 of them syntheses that pooled it.
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Who cites it
20 citing papers in PubMed, 3 syntheses or guidelines pooled it, 40 citations in OpenAlex.
- Complement-activating donor-specific anti-HLA antibodies in solid organ transplantation: systematic review, meta-analysis, and critical appraisal.Frontiers in immunology · 2023Pooled it
- Association between transplant glomerulopathy and graft outcomes following kidney transplantation: A meta-analysis.PloS one · 2020Pooled it
- Complement-activating donor-specific anti-HLA antibodies and solid organ transplant survival: A systematic review and meta-analysis.PLoS medicine · 2018Pooled it
- Tailoring HLA antibody monitoring post-transplantation.Pediatric nephrology (Berlin, Germany) · 2026Article
- Association of intraindividual tacrolimus variability with de novo donor-specific HLA antibody development and allograft rejection in pediatric kidney transplant recipients with low immunological risk.Pediatric nephrology (Berlin, Germany) · 2022Article
- Complement-Binding Donor-Specific Anti-HLA Antibodies: Biomarker for Immunologic Risk Stratification in Pediatric Kidney Transplantation Recipients.Transplant international : official journal of the European Society for Organ Transplantation · 2022Article
- 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
- C3d-Positive Preformed DSAs Tend to Persist and Result in a Higher Risk of AMR after Kidney Transplants.Journal of clinical medicine · 2020Article
- Biomarkers to detect rejection after kidney transplantation.Pediatric nephrology (Berlin, Germany) · 2018Review
- Complement-Activating Anti-HLA Antibodies in Kidney Transplantation: Allograft Gene Expression Profiling and Response to Treatment.Journal of the American Society of Nephrology : JASN · 2018Article
- Clinical risk stratification of paediatric renal transplant recipients using C1q and C3d fixing of de novo donor-specific antibodies.Pediatric nephrology (Berlin, Germany) · 2018Article
- HLA epitope matching in pediatric renal transplantation.Pediatric nephrology (Berlin, Germany) · 2017Review
- Application, technical issues, and interpretation of C1q for graft outcome.Current opinion in organ transplantation · 2017Review
- Complement Recognition Pathways in Renal Transplantation.Journal of the American Society of Nephrology : JASN · 2017Review
- Value of Donor-Specific Anti-HLA Antibody Monitoring and Characterization for Risk Stratification of Kidney Allograft Loss.Journal of the American Society of Nephrology : JASN · 2017Article
- From Humoral Theory to Performant Risk Stratification in Kidney Transplantation.Journal of immunology research · 2017Review
- Clinical Relevance of HLA Antibodies in Kidney Transplantation: Recent Data from the Heidelberg Transplant Center and the Collaborative Transplant Study.Journal of immunology research · 2017Review
- The Banff 2015 Kidney Meeting Report: Current Challenges in Rejection Classification and Prospects for Adopting Molecular Pathology.American journal of transplantation : official journal of the American Society of Transplantation and the American Society of Transplant Surgeons · 2017Article
- Unraveling the Role of Allo-Antibodies and Transplant Injury.Frontiers in immunology · 2016Review
- The Biological Effects of IL-21 Signaling on B-Cell-Mediated Responses in Organ Transplantation.Frontiers in immunology · 2016Review
Corrections and comments
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Authors and funding
9 authors at 2 institutions in 1 country.
Funding
No grant is acknowledged in the PubMed record.
Abstract
backgroundWe investigated the prognostic value of overall and complement-binding donor-specific HLA antibodies (DSA) in pediatric patients undergoing clinically indicated graft biopsies and their association with graft outcome and specific histological lesions.
methodsSera of 62 patients at time of indication biopsy ≥1 year posttransplant were assessed for DSA and C1q-fixing DSA by single-antigen bead (SAB) technology.
resultsTwenty-six patients (42 %) were DSA-positive at time of indication biopsy and nine (15 %) were C1q-positive. At 4 years postbiopsy, patients with C1q-positivity had a low graft survival (11 %) compared to DSA-positive, C1q-negative patients (82 %, p = 0.001) and to DSA-negative patients (88 %, p < 0.001). The majority (89 %) of C1q-positive patients were diagnosed with active chronic antibody-mediated rejection (ABMR). C1q DSA-positivity [adjusted hazard ratio (HR) 6.35], presence of transplant glomerulopathy (HR 9.54), and estimated glomerular filtration rate (eGFR) at the time of indication biopsy (HR 0.91) were risk factors for subsequent graft loss.
conclusionsThe presence of C1q-positive DSA in the context of an indication biopsy identifies a subgroup of pediatric renal transplant recipients with a markedly increased risk of subsequent graft loss. Because a fraction of DSA-positive patients escape rejection or graft dysfunction, the C1q assay increases the specificity of a positive DSA result regarding unfavorable transplant outcome.
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Registered trials
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.