Evidence map›Paper›PMID 39635538›Full record

ArticleFrontiers in immunology2024

HLA class, calcineurin inhibitor levels, and the risk of graft failure in kidney recipients with

Marc-Antoine Béland, Isabelle Lapointe, Isabelle Côté, Julie Lesage, Isabelle Houde, Eric Wagner, Julie Riopel, Eva Latulippe, Olivier Désy, Sacha A De Serres

Abstract read
PubMed Full text at PMC Publisher
In one paragraph

Article in Frontiers in immunology, 2024. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 1 paper.

0numbers the graph read from it
0cells of the map it votes in
1citing papers in PubMed
–field-weighted citation impact
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

1 citing paper in PubMed.

  1. Review
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.

Marc-Antoine BélandTransplantation Unit, Renal Division, Department of Medicine, University Health Center (CHU) of Quebec, Faculty of Medicine, Laval University, Quebec, QC, Canada.
Isabelle LapointeTransplantation Unit, Renal Division, Department of Medicine, University Health Center (CHU) of Quebec, Faculty of Medicine, Laval University, Quebec, QC, Canada.
Isabelle CôtéTransplantation Unit, Renal Division, Department of Medicine, University Health Center (CHU) of Quebec, Faculty of Medicine, Laval University, Quebec, QC, Canada.
Julie LesageTransplantation Unit, Renal Division, Department of Medicine, University Health Center (CHU) of Quebec, Faculty of Medicine, Laval University, Quebec, QC, Canada.
Isabelle HoudeTransplantation Unit, Renal Division, Department of Medicine, University Health Center (CHU) of Quebec, Faculty of Medicine, Laval University, Quebec, QC, Canada.
Eric WagnerImmunology and Histocompatibility Laboratory, University Health Center (CHU) of Quebec, Faculty of Medicine, Laval University, Quebec, QC, Canada.
Julie RiopelDepartment of Pathology, University Health Center (CHU) of Quebec, Faculty of Medicine, Laval University, Quebec, QC, Canada.
Eva LatulippeDepartment of Pathology, University Health Center (CHU) of Quebec, Faculty of Medicine, Laval University, Quebec, QC, Canada.
Olivier DésyTransplantation Unit, Renal Division, Department of Medicine, University Health Center (CHU) of Quebec, Faculty of Medicine, Laval University, Quebec, QC, Canada.
Sacha A De SerresTransplantation Unit, Renal Division, Department of Medicine, University Health Center (CHU) of Quebec, Faculty of Medicine, Laval University, Quebec, QC, Canada.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

Introduction: De novo donor-specific HLA antibody (dnDSA) are associated with poor outcomes. Whether this observation applies to both HLA class I and II dnDSA remains unclear. Methods: We studied 1236 consecutive kidney recipients who had routine anti-HLA antibody surveillance post-transplant. Results: During the screening period, 55/1236 (4.4%) patients developed dnDSA: 18 (33%) HLA-I only, 33 (60%) HLA-II only, and 4 (7%) both classes. Thirty patients experienced graft loss at a median of 39 months after dnDSA detection: 9/18 (50%) HLA-I only, 17/33 (52%) HLA-II only, and 4/4 (100%) both classes. A control group was created by matching patients with dnDSA to patients who did not develop DSA and had a functioning graft at the time of dnDSA detection in their respective cases. Compared with these controls, the risk estimates of graft loss were similar between patients with HLA-I only and HLA-II only dnDSA (aHR [95% CI] 2.7 [1.1-6.6], p=0.04 and 3.1 [1.5-6.6], p<0.01 respectively). Additionally, the risk of graft loss decreased with increasing CNI trough levels following dnDSA detection (aHR 0.7 [0.6-0.9] for each increase in 1 ng/mL, p=0.02). Conclusions: The prognosis of patients with dnDSA is similar regardless of the HLA class specificity. Lower calcineurin inhibitor levels predict graft loss in such patients.

Indexed as

Calcineurin InhibitorsGraft RejectionIsoantibodiesKidney TransplantationTissue DonorsAdultAgedFemaleGraft SurvivalHistocompatibility Antigens Class IHLA AntigensHumansMaleMiddle AgedRisk FactorsCalcineurin InhibitorsHistocompatibility Antigens Class IHLA AntigensIsoantibodiesanti-HLA alloantibodiesdonor-specific alloantibodiesgraft lossHLA class 1kidney transplantation

Identifiers

PMID39635538
PMCPMC11614807

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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.