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Cited by 493

The DOI matches its Crossref record; 20 of the 20 references it cites were found in a registry or an index.

Evidence for Antibody-Mediated Injury as a Major Determinant of Late Kidney Allograft Failure

Gaston, Robert S., Cecka, J. Michael, Kasiske, Bert L., Fieberg, Ann M., Leduc, Robert, Cosio, Fernando C., Gourishankar, Sita, Grande, Joseph, Halloran, Philip, Hunsicker, Lawrence, Mannon, Roslyn, Rush, David, Matas, Arthur J.·2010·Transplantation
DOI 10.1097/tp.0b013e3181e065de
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Abstract

BACKGROUND: Late graft failure (LGF) is believed to be the consequence of immunologic and nonimmunologic insults leading to progressive deterioration in kidney function. We studied recipients with new onset late kidney graft dysfunction (n=173) to determine the importance of C4d staining and circulating donor-specific antibody (DSA) in subsequent LGF. METHODS: One hundred seventy-three subjects transplanted before October 1, 2005 (mean time after transplant 7.3+/-6.0 years) had a baseline serum creatinine level of 1.4+/-0.3 mg/dL before January 1, 2006 and underwent biopsy for new onset graft dysfunction after that date (mean creatinine at biopsy 2.7+/-1.6 mg/dL). Statistical analysis was based on central DSA and blinded pathology determinations. RESULTS: Subjects were divided into four groups based on C4d and DSA: no C4d, no DSA (group A; n=74); only DSA (group B; n=31); only C4d (group C; n=28); and both C4d and DSA (group D; n=40). Among DSA+ recipients (groups B and D), group D had broader reactivity and a stronger DSA response. After 2 years, groups C and D (C4d+) were at significantly greater risk for LGF than groups A and B. Adjusting for inflammation (Banff i, t, g, and ptc scores) did not change the outcome. Local diagnosis of calcineurin inhibitor nephrotoxicity was spread across all four subgroups and did not impact risk of LGF. CONCLUSIONS: Evidence of antibody-mediated injury (DSA or C4d) is common (57%) in patients with new onset late kidney allograft dysfunction. The risk of subsequent graft failure is significantly worse in the presence of C4d+ staining.

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Metadata

Authors
Gaston, R. S., Cecka, J. M., Kasiske, B. L., Fieberg, A. M., Leduc, R., Cosio, F. C., Gourishankar, S., Grande, J., Halloran, P., Hunsicker, L., Mannon, R., Rush, D., & Matas, A. J.
Venue
Transplantation
Publisher
Ovid Technologies (Wolters Kluwer Health)
Published
2010-07-15
Volume
90
Issue
1
Pages
68-74
ISSN
0041-1337 (ISSN-L)
DOI
10.1097/tp.0b013e3181e065de
OpenAlex
W1978045461
Cited by
493
References
20
FWCI
28.05
Type
journal article
Language
en
Open access
closed

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CoChat. (2026). Citation check: Evidence for Antibody-Mediated Injury as a Major Determinant of Late Kidney Allograft Failure. https://app.cochat.ai/papers/10.1097/tp.0b013e3181e065de
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Gaston, R. S., Cecka, J. M., Kasiske, B. L., Fieberg, A. M., Leduc, R., Cosio, F. C., Gourishankar, S., Grande, J., Halloran, P., Hunsicker, L., Mannon, R., Rush, D., & Matas, A. J. (2010). Evidence for Antibody-Mediated Injury as a Major Determinant of Late Kidney Allograft Failure. Transplantation. https://doi.org/10.1097/tp.0b013e3181e065de

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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.