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논문분류	춘계학술대회 초록집
제목	Efficacy of the C3d assay for Prediction of Antibody-mediated Rejection in Kidney Transplant Recipients with Donor Specific Anti-HLA Antibodies
저자	Woo Yeong Park1, Wonmok Lee2, Sang Mok Yeo1, Hayeon Park1, Jin Hyuk Paek1, Seong Sik Kang1, Kyubok Jin1, Sung Bae Park1, Namhee Ryoo2, Seungyeup Han1
출판정보	2018; 2018(1):
키워드	Kidney transplantation \| Complement C3d \| Antibodies \| Graft rejection \| Graft survival
초록	Objectives: Donor specific antibody (DSA) is an essential factor for antibody-mediated rejection (AMR), but not all patients with DSA are diagnosed with AMR. The aim of this study was to investigate the association between DSA identified by single antigen bead (SAB) assay and C3d positive DSA with allograft biopsy findings in AMR. Methods: Stored sera from 24 kidney transplant recipients (KTRs) with DSA confirmed by SAB assay were tested using the C3d assay on Luminex platform. We compared clinical parameters, pathologic findings, and clinical outcome according to the positivity of C3d assay. Results: Among them, 11 KTRs had C3d positive DSA. There was no significant difference of mean age of donor and recipient between the C3d (-) and C3d (+) groups. There were also no significant differences of the proportions of gender, previous rejection, delayed graft function, frequency of KT, and KT type between the two groups. Most KTRs had the more anti-HLA class II DSA compared with anti-HLA-class I DSA (91.7% vs. 33.3%). Mean MFI of anti-HLA class II DSA was significantly higher in the C3d (+) group compared with the C3d (-) group (7,918 ± 4,477 vs. 2,592 ± 1,825, P = 0.003). There was positive correlation in the mean MFI of anti-HLA class II DSA between SAB and C3d assays. The proportion of acute AMR was significantly higher in the C3d (+) group compared with the C3d (-) group (75.0 % vs. 11.1%, P = 0.041). Death-censored graft survival showed no significant difference between the two groups. Conclusions: In our study, DSA identified by the SAB assay and C3d positive DSA by the C3d assay might be highly relevant, and in particular, the C3d assay seems to better reflect acute AMR. Therefore, in cases of suspected acute AMR, the C3d assay is recommended to be performed with the SAB assay.
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