SynthesisPLoS medicine2018
Complement-activating donor-specific anti-HLA antibodies and solid organ transplant survival: A systematic review and meta-analysis.
Synthesis in PLoS medicine, 2018. The graph could read no effect estimate from its abstract, so it casts no vote on the map. An erratum has been issued. It is linked to trial NCT03438058 (Complement-activating Anti-human Leucocyte Antigen Donor Specific Antibodies in Solid Organ Transplantation), which is not on this map. Cited by 38 papers, 3 of them syntheses 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.
Complement-activating Anti-human Leucocyte Antigen Donor Specific Antibodies in Solid Organ Transplantation: A Systematic Review and Meta-analysis
Who cites it
38 citing papers in PubMed, 3 syntheses or guidelines pooled it, 104 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
- Pooled it
- Safety and efficacy of eculizumab in the prevention of antibody-mediated rejection in living-donor kidney transplant recipients requiring desensitization therapy: A randomized trial.American journal of transplantation : official journal of the American Society of Transplantation and the American Society of Transplant Surgeons · 2019Trial
- Tailoring HLA antibody monitoring post-transplantation.Pediatric nephrology (Berlin, Germany) · 2026Article
- Kidney transplantation in Lupus Nephritis: a comprehensive review of challenges and strategies.BMC surgery · 2025Review
- Pushing the Survival Bar Higher: Two Decades of Innovation in Lung Transplantation.Journal of clinical medicine · 2024Review
- Targeting THaematologica · 2024Article
- IgG hexamers initiate acute lung injury.bioRxiv : the preprint server for biology · 2024Article
- Antibody-Mediated Rejection in Lung Transplantation: Diagnosis and Therapeutic Armamentarium in a 21st Century Perspective.Transplant international : official journal of the European Society for Organ Transplantation · 2024Review
- De Novo Donor-Specific Antibodies after Heart Transplantation: A Comprehensive Guide for Clinicians.Journal of clinical medicine · 2023Review
- Preventative effect of TSPO ligands on mixed antibody-mediated rejection through a Mitochondria-mediated metabolic disorder.Journal of translational medicine · 2023Article
- Optimized immunosuppression to prevent graft failure in renal transplant recipients with HLA antibodies (OuTSMART): a randomised controlled trial.EClinicalMedicine · 2023Article
- The Clinical Utility of Post-Transplant Monitoring of Donor-Specific Antibodies in Stable Renal Transplant Recipients: A Consensus Report With Guideline Statements for Clinical Practice.Transplant international : official journal of the European Society for Organ Transplantation · 2023Article
- Imlifidase for Kidney Transplantation of Highly Sensitized Patients With a Positive Crossmatch: The French Consensus Guidelines.Transplant international : official journal of the European Society for Organ Transplantation · 2023Article
- De Novo Complement-Binding Anti-HLA Antibodies in Heart Transplanted Patients Is Associated with Severe Cardiac Allograft Vasculopathy and Poor Long-Term Survival.Journal of clinical medicine · 2022Article
- Inhibition of complement activation by CD55 overexpression in human induced pluripotent stem cell derived kidney organoids.Frontiers in immunology · 2022Article
- Complement-targeted therapies in kidney transplantation-insights from preclinical studies.Frontiers in immunology · 2022Review
- Serum Soluble B Cell-Activating Factor Is a Non-Invasive Biomarker of Antibody-Mediated Rejection in Kidney Allograft With Satisfactory Risk Stratification Performance But Negligible Diagnostic Value.Frontiers in immunology · 2022Article
- Surrogate Endpoints for Late Kidney Transplantation Failure.Transplant international : official journal of the European Society for Organ Transplantation · 2022Article
Corrections and comments
- Erratum issued
Authors and funding
28 authors at 17 institutions in 8 countries.
Funding
No grant is acknowledged in the PubMed record.
Abstract
backgroundAnti-human leukocyte antigen donor-specific antibodies (anti-HLA DSAs) are recognized as a major barrier to patients' access to organ transplantation and the major cause of graft failure. The capacity of circulating anti-HLA DSAs to activate complement has been suggested as a potential biomarker for optimizing graft allocation and improving the rate of successful transplantations. METHODS AND
findingsTo address the clinical relevance of complement-activating anti-HLA DSAs across all solid organ transplant patients, we performed a meta-analysis of their association with transplant outcome through a systematic review, from inception to January 31, 2018. The primary outcome was allograft loss, and the secondary outcome was allograft rejection. A comprehensive search strategy was conducted through several databases (Medline, Embase, Cochrane, and Scopus). A total of 5,861 eligible citations were identified. A total of 37 studies were included in the meta-analysis. Studies reported on 7,936 patients, including kidney (n = 5,991), liver (n = 1,459), heart (n = 370), and lung recipients (n = 116). Solid organ transplant recipients with circulating complement-activating anti-HLA DSAs experienced an increased risk of allograft loss (pooled HR 3.09; 95% CI 2.55-3.74, P = 0.001; I2 = 29.3%), and allograft rejection (pooled HR 3.75; 95% CI: 2.05-6.87, P = 0.001; I2 = 69.8%) compared to patients without complement-activating anti-HLA DSAs. The association between circulating complement-activating anti-HLA DSAs and allograft failure was consistent across all subgroups and sensitivity analyses. Limitations of the study are the observational and retrospective design of almost all included studies, the higher proportion of kidney recipients compared to other solid organ transplant recipients, and the inclusion of fewer studies investigating allograft rejection.
conclusionsIn this study, we found that circulating complement-activating anti-HLA DSAs had a significant deleterious impact on solid organ transplant survival and risk of rejection. The detection of complement-activating anti-HLA DSAs may add value at an individual patient level for noninvasive biomarker-guided risk stratification.
trial registrationNational Clinical Trial protocol ID: NCT03438058.
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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.