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The natural history for patients with de novo donor-specific antibodies (dnDSA) and the risk factors for its development have not been well defined. Furthermore, clinical and histologic correlation with serologic data is limited. We studied 315 consecutive renal transplants without pretransplant DSA, with a mean follow-up of 6.2 ± 2.9 years. Protocol (n =(More)
Understanding rates and determinants of clinical pathologic progression for recipients with de novo donor-specific antibody (dnDSA), especially subclinical dnDSA, may identify surrogate endpoints and inform clinical trial design. A consecutive cohort of 508 renal transplant recipients (n = 64 with dnDSA) was studied. Recipients (n = 388) without dnDSA or(More)
Secondary hyperparathyroidism is a common complication of end-stage renal disease (ESRD), which occurs as a result of hyperphosphataemia, hypovitaminosis D and hypocalcaemia. Chronic hyperparathyroidism can result in osteitis fibrosis cystica, also known as brown tumours. Spinal cord compression from a brown tumour is a rare emergency and of the eight(More)
De novo donor-specific antibody (dnDSA) develops in 15-25% of renal transplant recipients within 5 years of transplantation and is associated with 40% lower graft survival at 10 years. HLA epitope matching is a novel strategy that may minimize dnDSA development. HLAMatchmaker software was used to characterize epitope mismatches at 395 potential HLA-DR/DQ/DP(More)
C1q-binding ability may indicate the clinical relevance of de novo donor-specific anti-HLA antibodies (DSA). This study investigated the incidence and risk factors for the appearance of C1q-binding de novo DSA and their long-term impact. Using Luminex Single Antigen Flow Bead assays, 346 pretransplant nonsensitized kidney recipients were screened at 2 and 5(More)
Predicting long-term outcomes in renal transplant recipients is essential to optimize medical therapy and determine the frequency of posttransplant histologic and serologic monitoring. Nonadherence and human leukocyte antigen (HLA) mismatch are risk factors that have been associated with poor long-term outcomes and may help individualize care. In the(More)
PURPOSE OF REVIEW To summarize the evidence supporting the negative impact of de novo donor-specific antibodies (dnDSA) in renal transplantation and to describe the natural history associated with the development of dnDSA. RECENT FINDINGS Recent studies have increased our appreciation of the risk factors that predispose to dnDSA while illuminating how(More)
BACKGROUND Early noninvasive markers that identify patients at risk of renal allograft loss may stratify patients for more intensive monitoring or therapy. CCL2 is a CCR2 receptor chemokine that is a chemoattractant protein for monocytes/macrophages, T cells, and natural killer cells. We have previously demonstrated in a multicenter cohort that urinary CCL2(More)
PURPOSE OF REVIEW To summarize the evidence concerning human leukocyte antigen (HLA) epitope mismatch analysis as a means to predict donor-specific antibody (DSA) development and allograft survival. RECENT FINDINGS HLA epitope mismatch analysis outperforms traditional whole molecule antigen mismatch for predicting the risk of de-novo DSA development. By(More)