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The DOI matches its Crossref record; 30 of the 30 references it cites were found in a registry or an index.

Complement-Binding Anti-HLA Antibodies and Kidney-Allograft Survival

Open access
Loupy, Alexandre, Lefaucheur, Carmen, Vernerey, Dewi, Prugger, Christof, van Huyen, Jean-Paul Duong, Mooney, Nuala, Suberbielle, Caroline, Frémeaux-Bacchi, Véronique, Méjean, Arnaud, Desgrandchamps, François, Anglicheau, Dany, Nochy, Dominique, Charron, Dominique, Empana, Jean-Philippe, Delahousse, Michel, Legendre, Christophe, Glotz, Denis, Hill, Gary S., Zeevi, Adriana, Jouven, Xavier·2013·New England Journal of Medicine

Abstract

BACKGROUND: Anti-HLA antibodies hamper successful transplantation, and activation of the complement cascade is involved in antibody-mediated rejection. We investigated whether the complement-binding capacity of anti-HLA antibodies plays a role in kidney-allograft failure. METHODS: We enrolled patients who received kidney allografts at two transplantation centers in Paris between January 1, 2005, and January 1, 2011, in a population-based study. Patients were screened for the presence of circulating donor-specific anti-HLA antibodies and their complement-binding capacity. Graft injury phenotype and the time to kidney-allograft loss were assessed. RESULTS: The primary analysis included 1016 patients. Patients with complement-binding donor-specific anti-HLA antibodies after transplantation had the lowest 5-year rate of graft survival (54%), as compared with patients with non-complement-binding donor-specific anti-HLA antibodies (93%) and patients without donor-specific anti-HLA antibodies (94%) (P<0.001 for both comparisons). The presence of complement-binding donor-specific anti-HLA antibodies after transplantation was associated with a risk of graft loss that was more than quadrupled (hazard ratio, 4.78; 95% confidence interval [CI], 2.69 to 8.49) when adjusted for clinical, functional, histologic, and immunologic factors. These antibodies were also associated with an increased rate of antibody-mediated rejection, a more severe graft injury phenotype with more extensive microvascular inflammation, and increased deposition of complement fraction C4d within graft capillaries. Adding complement-binding donor-specific anti-HLA antibodies to a traditional risk model improved the stratification of patients at risk for graft failure (continuous net reclassification improvement, 0.75; 95% CI, 0.54 to 0.97). CONCLUSIONS: Assessment of the complement-binding capacity of donor-specific anti-HLA antibodies appears to be useful in identifying patients at high risk for kidney-allograft loss.

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Metadata

Authors
Loupy, A., Lefaucheur, C., Vernerey, D., Prugger, C., van Huyen, J.-P. D., Mooney, N., Suberbielle, C., Frémeaux-Bacchi, V., Méjean, A., Desgrandchamps, F., Anglicheau, D., Nochy, D., Charron, D., Empana, J.-P., Delahousse, M., Legendre, C., Glotz, D., Hill, G. S., Zeevi, A., & Jouven, X.
Venue
New England Journal of Medicine
Published
2013-09-26
Volume
369
Issue
13
Pages
1215-1226
ISSN
  • 0028-4793 (ISSN-L)
  • 1533-4406
OpenAlex
W2115660072
Cited by
852
References
30
FWCI
60.74
Type
journal article
Language
en
Open access
bronze

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CoChat. (2026). Citation check: Complement-Binding Anti-HLA Antibodies and Kidney-Allograft Survival. https://app.cochat.ai/papers/10.1056/nejmoa1302506
The paper
Loupy, A., Lefaucheur, C., Vernerey, D., Prugger, C., van Huyen, J.-P. D., Mooney, N., Suberbielle, C., Frémeaux-Bacchi, V., Méjean, A., Desgrandchamps, F., Anglicheau, D., Nochy, D., Charron, D., Empana, J.-P., Delahousse, M., Legendre, C., Glotz, D., Hill, G. S., Zeevi, A., & Jouven, X. (2013). Complement-Binding Anti-HLA Antibodies and Kidney-Allograft Survival. New England Journal of Medicine. https://doi.org/10.1056/nejmoa1302506

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Contains information from the Semantic Scholar Academic Graph Datasets, made available under the ODC Attribution License (ODC-BY 1.0).

Semantic Scholar’s data is described in: Kinney, R., et al. (2023). The Semantic Scholar Open Data Platform. arXiv:2301.10140.