Complement-activating donor-specific anti-HLA antibodies and solid organ transplant survival: A systematic review and meta-analysis

Antoine Bouquegneau, Charlotte Loheac, Olivier Aubert, Yassine Bouatou, Denis Viglietti, Jean–Philippe Empana, Camilo Ulloa, Mohammad Hassan Murad, Christophe Legendre, Denis Glotz, Annette M Jackson, Adriana Zeevi, Stephan Schaub, Jean–Luc Taupin, Elaine F Reed, John J Friedewald, Dolly B Tyan, Caner Süsal, Ron Shapiro, E Steve Woodle, Luis G Hidalgo, Jacqueline O’Leary, Robert A Montgomery, Jon Kobashigawa, Xavier Jouven, Patricia Jabre, Carmen Lefaucheur and Alexandre Loupy

PLOS Medicine, 2018, vol. 15, issue 5, 1-25

Abstract: Background: Anti-human leukocyte antigen donor-specific antibodies (anti-HLA DSAs) are recognized as a major barrier to patients’ access to organ transplantation and the major cause of graft failure. The capacity of circulating anti-HLA DSAs to activate complement has been suggested as a potential biomarker for optimizing graft allocation and improving the rate of successful transplantations. Methods and findings: To address the clinical relevance of complement-activating anti-HLA DSAs across all solid organ transplant patients, we performed a meta-analysis of their association with transplant outcome through a systematic review, from inception to January 31, 2018. The primary outcome was allograft loss, and the secondary outcome was allograft rejection. A comprehensive search strategy was conducted through several databases (Medline, Embase, Cochrane, and Scopus). Conclusions: In this study, we found that circulating complement-activating anti-HLA DSAs had a significant deleterious impact on solid organ transplant survival and risk of rejection. The detection of complement-activating anti-HLA DSAs may add value at an individual patient level for noninvasive biomarker-guided risk stratification. Trial registration: National Clinical Trial protocol ID: NCT03438058. In a systematic review and meta-analysis, Alexandre Loupy and colleagues study antibody biomarkers of solid organ transplantation outcomes.Why was this study done?: What did the researchers do and find?: What do these findings mean?:

Date: 2018
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Persistent link: https://EconPapers.repec.org/RePEc:plo:pmed00:1002572

DOI: 10.1371/journal.pmed.1002572

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