dc.contributor.author |
Crespo, Elena |
dc.contributor.author |
Lucia, Marc |
dc.contributor.author |
Cruzado, Josep Ma. |
dc.contributor.author |
Luque, Sergio |
dc.contributor.author |
Melilli, Edoardo |
dc.contributor.author |
Manonelles, Anna |
dc.contributor.author |
Lloberas Blanch, Núria |
dc.contributor.author |
Torras Ambròs, Joan |
dc.contributor.author |
Grinyó Boira, Josep M. |
dc.contributor.author |
Bestard Matamoros, Oriol |
dc.date |
2017-05-18T07:12:53Z |
dc.date |
2017-05-18T07:12:53Z |
dc.date |
2015-02-17 |
dc.date |
2017-05-18T07:12:53Z |
dc.identifier.citation |
1932-6203 |
dc.identifier.citation |
654076 |
dc.identifier.uri |
http://hdl.handle.net/2445/111203 |
dc.format |
14 p. |
dc.format |
application/pdf |
dc.language.iso |
eng |
dc.publisher |
Public Library of Science (PLoS) |
dc.relation |
Reproducció del document publicat a: https://doi.org/10.1371/journal.pone.0117618 |
dc.relation |
PLoS One, 2015, vol. 10, num. 2, p. e0117618 |
dc.relation |
https://doi.org/10.1371/journal.pone.0117618 |
dc.rights |
cc-by (c) Crespo, Elena et al., 2015 |
dc.rights |
info:eu-repo/semantics/openAccess |
dc.rights |
http://creativecommons.org/licenses/by/3.0/es |
dc.subject |
Trasplantament d'òrgans |
dc.subject |
Trasplantament renal |
dc.subject |
Cèl·lules T |
dc.subject |
Rebuig (Biologia) |
dc.subject |
Transplantation of organs |
dc.subject |
Kidney transplantation |
dc.subject |
T cells |
dc.subject |
Graft rejection |
dc.title |
Pre-transplant donor-specific T-cell alloreactivity is strongly associated with early acute cellular rejection in kidney transplant recipients not receiving T-cell depleting induction therapy |
dc.type |
info:eu-repo/semantics/article |
dc.type |
info:eu-repo/semantics/publishedVersion |
dc.description.abstract |
Preformed T-cell immune-sensitization should most likely impact allograft outcome during the initial period after kidney transplantation, since donor-specific memory T-cells may rap- idly recognize alloantigens and activate the effector immune response, which leads to allo- graft rejection. However, the precise time-frame in which acute rejection is fundamentally triggered by preformed donor-specific memory T cells rather than by denovo activated na ï ve T cells is still to be established. Here, preformed donor-specific alloreactive T-cell re- sponses were evaluated using the IFN- γ ELISPOT assay in a large consecutive cohort of kidney transplant patients (n = 90), to assess the main clinical variables associated with cel- lular sensitization and its predominant time-frame impact on allograft outcome, and was fur- ther validated in an independent new set of kidney transplant recipients (n = 67). We found that most highly T-cell sensitized patients were elderly patients with particularly poor HLA class-I matching, without any clinically recognizable sensitizing events. While one-year inci- dence of all types of biopsy-proven acute rejection did not differ between T-cell alloreactive and non-alloreactive patients, Receiver Operating Characteristic curve analysis indicated the first two months after transplantation as the highest risk time period for acute cellular re- jection associated with baseline T-cell sensitization. This effect was particularly evident in young and highly alloreactive individuals that did not receive T-cell depletion immunosup- pression. Multivariate analysis confirmed preformed T-cell sensitization as an independent predictor of early acute cellular rejection. In summary, monitoring anti-donor T-cell sensiti- zation before transplantation may help to identify patients at increased risk of acute cellular rejection, particularly in the early phases after kidney transplantation, and thus guide decision-making regarding the use of induction therapy. |