Age-associated decrease in de novo donor-specific antibodies in renal transplant recipients reflects changing humoral immunity
Abstract Background Older age at organ transplantation is associated with increased risk of infection and malignancy but reduced risk of cellular rejection. De novo donor-specific anti-HLA antibodies (dnDSA), are key biomarkers associated with reduced long-term allograft survival, yet there is a lac...
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| Format: | Article |
| Language: | English |
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BMC
2019-05-01
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| Series: | Immunity & Ageing |
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| Online Access: | http://link.springer.com/article/10.1186/s12979-019-0149-8 |
| _version_ | 1811322856151187456 |
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| author | Seraina von Moos Gesa Schalk Thomas F. Mueller Guido Laube |
| author_facet | Seraina von Moos Gesa Schalk Thomas F. Mueller Guido Laube |
| author_sort | Seraina von Moos |
| collection | DOAJ |
| description | Abstract Background Older age at organ transplantation is associated with increased risk of infection and malignancy but reduced risk of cellular rejection. De novo donor-specific anti-HLA antibodies (dnDSA), are key biomarkers associated with reduced long-term allograft survival, yet there is a lack of data focusing on age-associated changes. Methods Development of dnDSA was restrospectively analyzed in all subjects who received a kidney transplant at the University Hospital Zurich between 01/2006 and 02/2015. Follow up continued until 03/2016. The incidence of dnDSA in different age categories was compared with special focus on the extremes of age: children < 10 years (n = 19) and adults ≥60 years of age (n = 110). Results Incidence of dnDSA gradually decreased with age, with older recipients having a significantly lower risk (HR 0.21, p = 0.0224) compared to pediatric recipients. Cumulative incidence of dnDSA at 2, 5 and 10 years was 6.2, 9.1 and 36% in the older recipients versus 5.3, 29.5 and 47.1% in pediatric recipients. Median time to development of dnDSA was similar (older 720 days, min 356, max 3646 days; children 1086 days, min 42, max 2474 days). Annual incidence was highest within the first two years after transplantation in the older recipients and peaked in years two to four in pediatric recipients. DnDSA were predominantly class II. More dnDSA were observed with cyclosporine as compared to tacrolimus. Conclusion Older kidney transplant recipients have a lower risk of developing dnDSA than pediatric recipients, pointing towards reduced humoral immune reactivity with increasing age. This observation raises the question of adjustment in immunosuppression. |
| first_indexed | 2024-04-13T13:42:43Z |
| format | Article |
| id | doaj.art-91c6f17fe407489fa1bd0d81512f2eff |
| institution | Directory Open Access Journal |
| issn | 1742-4933 |
| language | English |
| last_indexed | 2024-04-13T13:42:43Z |
| publishDate | 2019-05-01 |
| publisher | BMC |
| record_format | Article |
| series | Immunity & Ageing |
| spelling | doaj.art-91c6f17fe407489fa1bd0d81512f2eff2022-12-22T02:44:35ZengBMCImmunity & Ageing1742-49332019-05-011611810.1186/s12979-019-0149-8Age-associated decrease in de novo donor-specific antibodies in renal transplant recipients reflects changing humoral immunitySeraina von Moos0Gesa Schalk1Thomas F. Mueller2Guido Laube3Department of Nephrology, University of Zurich and University Hospital ZurichDepartment of Nephrology, University of Zurich and University Children’s HospitalDepartment of Nephrology, University of Zurich and University Hospital ZurichDepartment of Nephrology, University of Zurich and University Children’s HospitalAbstract Background Older age at organ transplantation is associated with increased risk of infection and malignancy but reduced risk of cellular rejection. De novo donor-specific anti-HLA antibodies (dnDSA), are key biomarkers associated with reduced long-term allograft survival, yet there is a lack of data focusing on age-associated changes. Methods Development of dnDSA was restrospectively analyzed in all subjects who received a kidney transplant at the University Hospital Zurich between 01/2006 and 02/2015. Follow up continued until 03/2016. The incidence of dnDSA in different age categories was compared with special focus on the extremes of age: children < 10 years (n = 19) and adults ≥60 years of age (n = 110). Results Incidence of dnDSA gradually decreased with age, with older recipients having a significantly lower risk (HR 0.21, p = 0.0224) compared to pediatric recipients. Cumulative incidence of dnDSA at 2, 5 and 10 years was 6.2, 9.1 and 36% in the older recipients versus 5.3, 29.5 and 47.1% in pediatric recipients. Median time to development of dnDSA was similar (older 720 days, min 356, max 3646 days; children 1086 days, min 42, max 2474 days). Annual incidence was highest within the first two years after transplantation in the older recipients and peaked in years two to four in pediatric recipients. DnDSA were predominantly class II. More dnDSA were observed with cyclosporine as compared to tacrolimus. Conclusion Older kidney transplant recipients have a lower risk of developing dnDSA than pediatric recipients, pointing towards reduced humoral immune reactivity with increasing age. This observation raises the question of adjustment in immunosuppression.http://link.springer.com/article/10.1186/s12979-019-0149-8De novo donor specific antibodiesAgingOlder kidney transplant recipientsPediatric kidney transplant recipientsImmunosenescence |
| spellingShingle | Seraina von Moos Gesa Schalk Thomas F. Mueller Guido Laube Age-associated decrease in de novo donor-specific antibodies in renal transplant recipients reflects changing humoral immunity Immunity & Ageing De novo donor specific antibodies Aging Older kidney transplant recipients Pediatric kidney transplant recipients Immunosenescence |
| title | Age-associated decrease in de novo donor-specific antibodies in renal transplant recipients reflects changing humoral immunity |
| title_full | Age-associated decrease in de novo donor-specific antibodies in renal transplant recipients reflects changing humoral immunity |
| title_fullStr | Age-associated decrease in de novo donor-specific antibodies in renal transplant recipients reflects changing humoral immunity |
| title_full_unstemmed | Age-associated decrease in de novo donor-specific antibodies in renal transplant recipients reflects changing humoral immunity |
| title_short | Age-associated decrease in de novo donor-specific antibodies in renal transplant recipients reflects changing humoral immunity |
| title_sort | age associated decrease in de novo donor specific antibodies in renal transplant recipients reflects changing humoral immunity |
| topic | De novo donor specific antibodies Aging Older kidney transplant recipients Pediatric kidney transplant recipients Immunosenescence |
| url | http://link.springer.com/article/10.1186/s12979-019-0149-8 |
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