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The clinicopathological relevance of pretransplant anti-angiotensin II type 1 receptor antibodies in renal transplantation.

 Juhan Lee  ;  Kyu Ha Huh  ;  Yongjung Park  ;  Borae G. Park  ;  Jaeseok Yang  ;  Jong Cheol Jeong  ;  Joongyup Lee  ;  Jae Berm Park  ;  Jang-Hee Cho  ;  Sik Lee  ;  Han Ro  ;  Seung-Yeup Han  ;  Myoung Soo Kim  ;  Yu Seun Kim  ;  Sung Joo Kim 
 Nephrology Dialysis Transplantation, Vol.32(7) : 1244-1250, 2017 
Journal Title
 Nephrology Dialysis Transplantation 
Issue Date
Adult ; Cohort Studies ; Female ; Graft Rejection/blood ; Graft Rejection/diagnosis ; Graft Rejection/etiology ; Humans ; Isoantibodies/blood ; Isoantibodies/immunology ; Kidney Transplantation/adverse effects ; Male ; Middle Aged ; Receptor, Angiotensin, Type 1/immunology ; Risk Factors
acute rejection ; angiotensin II type 1 receptor antibody ; antibody-mediated injury ; pretransplant ; renal transplantation
Background: Anti-angiotensin II type 1 receptor antibodies (AT1R-Abs) have been suggested as a risk factor for graft failure and acute rejection (AR). However, the prevalence and clinical significance of pretransplant AT1R-Abs have seldom been evaluated in Asia. Methods: In this multicenter, observational cohort study, we tested the AT1R-Abs in pretransplant serum samples obtained from 166 kidney transplant recipients. Statistical analysis was used to set a threshold AT1R-Abs level at 9.05 U/mL. Results: Pretransplant AT1R-Abs were detected in 98/166 (59.0%) of the analyzed recipients. No graft loss or patient death was reported during the study period. AT1R-Abs (+) patients had a significantly higher incidence of biopsy-proven AR than AT1R-Abs (-) patients (27.6 versus 10.3%, P = 0.007). Recipients with pretransplant AT1R-Abs had a 3.2-fold higher risk of AR within a year of transplantation (P = 0.006). Five study subjects developed microcirculation inflammation (score ≥2). Four of them were presensitized to AT1R-Abs. In particular, three patients had a high titer of anti-AT1R-Abs (>22.7 U/mL). Conclusions: Pretransplant AT1R-Abs is an independent risk factor for AR, especially acute cellular rejection, and is possibly associated with the risk of antibody-mediated injury. Pretransplant assessment of AT1R-Abs may be useful for stratifying immunologic risks.
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1. College of Medicine (의과대학) > Dept. of Surgery (외과학교실) > 1. Journal Papers
1. College of Medicine (의과대학) > Dept. of Laboratory Medicine (진단검사의학교실) > 1. Journal Papers
Yonsei Authors
김명수(Kim, Myoung Soo) ORCID logo https://orcid.org/0000-0002-8975-8381
김유선(Kim, Yu Seun) ORCID logo https://orcid.org/0000-0002-5105-1567
박금보래(Park, Borae G)
이주한(Lee, Ju Han)
허규하(Huh, Kyu Ha) ORCID logo https://orcid.org/0000-0003-1364-6989
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