Posttransplant soluble B-cell activating factor kinetics in pediatric recipients of first kidney allograft

Patrizia Comoli, Giuseppe Quartuccio, Michela Cioni, Angelica Parodi, Arcangelo Nocera, Sabrina Basso, Iris Fontana, Alberto Magnasco, Viviana Sioli, Ilaria Guido, Catherine Klersy, Marco Zecca, Massimo Cardillo, Gian Marco Ghiggeri, Fabrizio Ginevri

Research output: Contribution to journalArticle

Abstract

Background. Development of de novo donor-specific antibodies (dnDSA) is associated with late or chronic antibody-mediated rejection (CAMR) and poor graft outcome in low-risk kidney transplant recipients. High-level soluble B-cell activating factor (sBAFF) was observed in kidney recipients at higher risk of developing dnDSA.

Methods. We longitudinally analyzed sBAFF levels in 81 consecutive primary pediatric kidney recipients monitored for de novo human leukocyte antigen (HLA) antibody (Ab) occurrence to gain insight into the events conditioning B-cell activation posttransplant and to analyze the usefulness of paired DSA-sBAFF monitoring in this clinical setting.

Results. At a median follow-up of 65 months, 23 patients (28%) developed dnDSA, with 13 of 23 developing CAMR. Irrespective of HLA Ab status, sBAFF levels progressively increased in all patients in the first posttransplant year, thereafter reaching a plateau. sBAFF levels were influenced by the degree of HLA class I antigen match and donor age. Despite higher levels of sBAFF in HLA Ab-positive patients (median and 95% confidence interval sBAFF in DSA+non-DSA patients: 568, 534-608 pg/mL vs. 502, 422-548 pg/mL in Ab-negative patients; P

Conclusion. Our findings provide evidence of early posttransplant B-cell activation even in unsensitized recipients of first kidney allograft. The significance of this activation, likely induced by exposition to the allograft, is yet unclear.

Original languageEnglish
Pages (from-to)243-249
Number of pages7
JournalTransplantation
Volume99
Issue number1
DOIs
Publication statusPublished - Jan 15 2015

ASJC Scopus subject areas

  • Transplantation
  • Medicine(all)

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