[Effect of pre-transplant donor specific antibody on antibody-mediated rejection and graft dysfunction]

To explore the effect of pre-transplant donor specific antibody (DSA) on antibody-mediated rejection (AMR) and function of transplanted kidney.

A total of 88 cases of renal transplant recipients were selected. Before surgery, DSA was examined by Luminex liquid phase chip in renal transplant recipients. The recipients were divided into a DSA positive group (n=20) and a DSA negative group (n=68). The follow-up time was 2 years. After the operation, the pathologic morphology of the transplanted kidney was evaluated and classified according to the Banff 2005 standard. The situation for the transplanted kidney was evaluated.

The incidence of AMR in the DSA positive group and negative group was 20% and 1.5%, respectively, with significant difference between them (P<0.01). The incidence of graft loss in the DSA positive group and negative group was 15% and 1.5%, respectively, with significant difference between them (P<0.05). The pre-transplant DSA associated with AMR at multiple mean fluorescence intensity (MFI) was obvious different from that without AMR (P<0.01). Receiver operating characteristic (ROC) curves showed that the maximal MFI threshold for recipients with AMR was 7909.5 after renal transplantation. There was no significant difference in the delayed recovery of renal graft function (DGF) between the 2 groups (P>0.05).

The detection of DSA level before renal transplantation can predict the risk of AMR and the function of transplanted kidney. The MFI intercept point of the highest DSA (MFI>
7909.5) can be used to predict the risk of AMR.