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Anticardiolipin antibodies and 12-month graft function in kidney transplant recipients: a prognosis cohort survey

2017; Oxford University Press; Volume: 33; Issue: 4 Linguagem: Inglês

10.1093/ndt/gfx353

1460-2385

Marion Gauthier, Florence Canouï‐Poitrine, Esther Guéry, Dominique Desvaux, Sophie Hüe, Guillaume Canaud, Thomas Stehlé, Philippe Lang, Tomek Kofman, Philippe Grimbert, Marie Matignon,

Renal Diseases and Glomerulopathies

In kidney transplant recipients, anticardiolipin (ACL) antibodies without antiphospholipid syndrome (APS) are found in up to 38% of patients and could be associated with thrombotic events (TEs). However, the prognostic role of ACL regarding kidney transplant and patients outcomes have still not been well defined. We conducted an observational, monocentric, retrospective cohort study including 446 kidney transplant recipients and standardized follow-up: 36-month allograft and patient survival, 12-month estimated glomerular filtration rate (eGFR) and 3- and 12-month screening biopsies. ACL tests were run on 247 patients, 101 were positive (ACL+ group, 41%) and 146 were negative (ACL– group, 59%). Allografts and patient survival within 36 months as TE were similar between both groups [hazard ratio (HR) = 1.18 and HR = 0.98, respectively]. The 12-month eGFR was significantly lower in the ACL+ group [median (95% confidence interval) 48.5 (35.1–60.3) versus 51.9 (39.1–65.0) mL/min/1.73 m2, P= 0.042]. ACL+ was independently associated with eGFR decrease (P = 0.04). In 12-month screening biopsies, tubular atrophy was significantly more severe in the ACL+ group compared with the ACL− group (P = 0.02). ACL without APS before kidney transplantation is an independent risk factor of eGFR decline within the first year post-transplant without over-incidence of TEs. Specific immunosuppressive therapy including mammalian target of rapamycin inhibitors should be discussed in the future.