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논문분류	춘계학술대회 초록집
제목	Clinical significance of Non-HLA Antibodies in the Development of Microcirculation Inflammation in Allograft Tissue after Kidney Transplantation
저자	Ji-Won Min* 1, 2, Hyeyoung Lee2, 3, Eun-Jee Oh2, 3, Byung Ha Chung1, 2, Chul Woo Yang1, 2
출판정보	2016; 2016(1):
키워드	Allograft survival, Kidney Transplantation, Microcirculation inflammation
초록	Background: The aim of our study is to determine the clinical significance of pre-transplant non-HLA antibodies, mainly those targeting the angiotenin II type I receptor (AT1R) and major histocompatibility complex class I-related chain A (MICA). Methods: We examined the presence of pre-transplant AT1R and MICA antibodies in 362 patients who underwent kidney transplantation. Patients were divided into groups according to the presence of AT1R and MICA antibodies: MICA only (n=28), AT1R only (n=150), MICA- +AT1R- (n=159), MICA+ +AT1R+ (n=22) groups. Clinical characteristics and immunological characteristics were compared among these groups. Patients who underwent post-transplant allograft biopsy (indicated biopsy for elevated creatinine (n=128) and protocol biopsy (n=124)) were further divided according to the presence of pre-transplant HLA-DSA, and pathologic biopsy findings and clinical outcomes were compared among groups. Results: There were no significant differences among the groups in baseline clinical and immunological characteristics. In biopsy findings, no significant differences were found in the development of AMR, but microvascular inflammation (glomerulitis + peritubular capillaritis) scores, representing humoral immunity, were significantly higher in the MICA or AT1R detected groups compared to groups without either antibodies (P<0.05). These findings were consistent in both indicated and protocol biopsy patients, especially in those without detectable HLA-DSA. Allograft survival was also significantly lower in patients positive for either MICA or AT1R antibodies, but negative for HLA-DSA (P<0.05). Conclusion: In conclusion, pre-transplant detection of MICA or AT1R antibody is significantly associated with the post-transplant development of microcirculation inflammation and poor allograft outcomes especially in those without HLA-DSA.
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