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논문분류	춘계학술대회 초록집
제목	Impact of Low Dose Donor Specific Anti-HLA Antibodies between Living Donor Versus Deceased Donor Kidney Transplantation
저자	Seong Gyu Kim, Yohan Park, Sua Lee, Eun Jeong Ko, Tae Hyun Ban, Hye Eun Yoon, Chul Woo Yang, Woo Yeong Park, Seungyeop Han, Byung Ha Chung
출판정보	2020; 2020(1):
키워드	donor specific antibody \| antibody mediated rejection \| allograft outcome \| kidney transplantation
초록	Presence of donor specific anti-HLA antibody (HLA-DSA) has significant impact on the short term and long term allograft outcomes after kidney transplantation. However, the impact of low dose HLA-DSA has not been fully investigated yet. The aim of this study is to investigate the impact of low dose HLA-DSA between living donor transplantation (LDKT) versus deceased donor kidney transplantation (DDKT). From January 2010 to December 2018, total 1178 Kidney transplantation recipients at Seoul St. Mary's Hospital and Dongsan Medical Center were enrolled. The low dose HLA-DSA was defined as positive DSAs and negative crossmatch. The primary outcome was the development of biopsy proven acute antibody mediated rejection (BP-ABMR) and the secondary outcomes were change of allograft function, death-censored graft loss rate and patient mortality. Of total 627 living donor kidney transplant recipients, 567 patients were negative HLA-DSA group and 60 patients were low dose HLA-DSA group. Of total 551 deceased donor kidney transplant recipients, 512 patients were negative HLA-DSA group and 39 patients were low dose HLA-DSA group. In LDKT, BP-ABMR was increased in the low dose HLA-DSA group than negative HLA-DSA group significantly. In multivariate analysis, the odds ratio of positive HLA-DSA class II in the low dose HLA-DSA group was 8.179 (2.916-22.945) but positive HLA-DSA class I and positive total HLA-DSA were not significant. In DDKT, BP-ABMR tended to increase in the low dose HLA-DSA group but was not significant. Change of allograft function, death-censored graft loss rate and patient mortality were not significantly different between the low dose HLA-DSA group and the negative HLA-DSA group in both LDKT and DDKT. Low dose HLA-DSA may be associated with increased BP-ABMR in LDKT. In low dose HLA-DSA, HLA-DSA class II may be an important role in increased BP-ABMR. However, the impact of low dose HLA-DSA is unclear in DDKT.
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