Evidence map›Paper›PMID 39524447›Full record

Observational studyFrontiers in immunology2024

Increased thrombin generation in kidney transplant recipients with donor-specific antibodies directed against human leukocyte antigens.

Linda Lóczi, Réka P Szabó, Rita Orbán-Kálmándi, Rebeka Hodossy-Takács, Anikó Szilvási, Zoltán Szalai, Gábor Nagy, Péter Antal-Szalmás, Balázs Nemes, Zsuzsa Bagoly

Abstract readObservational Study
PubMed Full text at PMC Publisher
In one paragraph

Observational study in Frontiers in immunology, 2024. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.

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0citing papers in PubMed
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1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

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.

2 · The registry

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.

3 · Its place in the literature

Who cites it

0 citing papers in PubMed.

No citing paper in PubMed yet.

4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

10 authors.

Linda LócziDivision of Clinical Laboratory Sciences, Department of Laboratory Medicine, Faculty of Medicine, Kálmán Laki Doctoral School, University of Debrecen, Debrecen, Hungary.
Réka P SzabóDivision of Nephrology, Department of Internal Medicine, University of Debrecen, Debrecen, Hungary.
Rita Orbán-KálmándiDivision of Clinical Laboratory Sciences, Department of Laboratory Medicine, Faculty of Medicine, Kálmán Laki Doctoral School, University of Debrecen, Debrecen, Hungary.
Rebeka Hodossy-TakácsDivision of Clinical Laboratory Sciences, Department of Laboratory Medicine, Faculty of Medicine, Kálmán Laki Doctoral School, University of Debrecen, Debrecen, Hungary.
Anikó SzilvásiTransplantation Immunogenetics Laboratory, Hungarian National Blood Transfusion Service, Budapest, Hungary.
Zoltán SzalaiDivision of Organ Transplantation, Department of Surgery, Faculty of Medicine, University of Debrecen, Debrecen, Hungary.
Gábor NagyDepartment of Laboratory Medicine, Faculty of Medicine, University of Debrecen, Debrecen, Hungary.
Péter Antal-SzalmásDepartment of Laboratory Medicine, Faculty of Medicine, University of Debrecen, Debrecen, Hungary.
Balázs NemesDivision of Organ Transplantation, Department of Surgery, Faculty of Medicine, University of Debrecen, Debrecen, Hungary.
Zsuzsa BagolyDivision of Clinical Laboratory Sciences, Department of Laboratory Medicine, Faculty of Medicine, Kálmán Laki Doctoral School, University of Debrecen, Debrecen, Hungary.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

Introduction: The development of Aims: We hypothesized that in kidney transplant recipients the presence of DSAs induce hemostasis alterations, including hypercoagulability, as assessed by the thrombin generation assay (TGA). Patients and methods. In this observational cohort study, 27 kidney transplant recipients with DSAs (DSA+ group) and 16 without DSAs (DSA- group) were enrolled. Venous blood samples were obtained, and besides routine laboratory tests, von Willebrand factor antigen (VWF), FVIII activity, soluble E selectin (sEsel), soluble P selectin (sPsel), TGA, clot lysis assay (CLA), complement levels (C3, C4) were measured. To correlate results with potential changes in DSA status over time, patients were followed and reassessed 6 ± 1.5 months later. Results: VWF and sPsel did not differ between groups, but both parameters were increased in the majority of patients. Endogenous thrombin potential (ETP) was significantly higher in the DSA+ group as compared to DSA- patients (median:1666; IQR:1438-2012 vs. 1230; IQR:1097-1659 nM*min, p=0.0019). Follow-up measurements indicated that the observed hemostasis alterations were not transient. CLA parameters, C3 and C4 did not differ between DSA+ and DSA- groups. The extent of anti-HLA II DSA positivity correlated positively with ETP, while tacrolimus levels negatively correlated with ETP and VWF/FVIII levels. Conclusions: In patients with anti-HLA class II DSAs, thrombin generation was significantly increased as compared to DSA- kidney transplant recipients, suggesting that the presence of antibodies is associated with hypercoagulability. Tacrolimus levels were negatively associated with TGA parameters. Hypercoagulability, associated with the presence of DSAs, may potentially contribute to the pathomechanism of antibody-mediated graft injury, warranting future prospective studies.

Indexed as

HLA AntigensIsoantibodiesKidney TransplantationThrombinAdultAgedFemaleGraft RejectionHumansMaleMiddle AgedTissue DonorsTransplant RecipientsHLA AntigensIsoantibodiesThrombinantibody-mediated rejectiondonor specific antibodyhemostasiskidney transplantationthrombin generation

Identifiers

PMID39524447
PMCPMC11543428

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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.