Antibody-mediated rejection in children after kidney transplantation
Authors:
J. Láchová 1; A. Slavčev 2; T. Seeman 1,3
Authors‘ workplace:
Pediatrická klinika 2. LF UK a Fakultní nemocnice Motol, Praha
1; Oddělení imunogenetiky, Pracoviště laboratorních metod, Institut klinické a experimentální medicíny, Praha
2; Biomedicínské centrum, Lékařská fakulta v Plzni, Univerzita Karlova, Plzeň
3
Published in:
Čes-slov Pediat 2019; 74 (6): 371-376.
Category:
Review
Overview
Kidney transplantation is the best therapeutic choice for children with end stage kidney disease. Antibody mediated rejection (AMR) has been recognized as the leading immunological cause of decline of graft function and graft loss in the long run. AMR is caused by antibodies specific to mismatched donor antigens, i.e. donor specific antibodies (DSA). According to the Banff classification of renal allograft pathology there are three criteria that need to be met for the diagnosis of AMR – detection of DSA in patient’s serum, morphologic features of graft lesion and proof of endothelium-antibody interaction, including the presence of C4d deposits in the peritubular capillaries in graft biopsy. The treatment of AMR remains challenging and requires combination of different modalities. The most commonly used protocols include series of plasmapheresis, intravenous immunoglobulins and rituximab application.
Keywords:
AMR – ABMR – humorální rejekce – Nephrology – pediatric nephrology – kidney transplantation – kidney transplantation in children – donor specific antibodies – DSA – plasma-exchange – IVIG – rituximab
Sources
1. Sellarés J, de Freitas DG, Halloran PF. Understanding the causes of kidney transplant failure: the dominant role of antibody-mediated rejection and nonadherence. Am J Transplant 2012 Feb; 12 (2): 388–399. doi: 10.1111/j.1600-6143.2011.03840.x. PubMed PMID: 22081892.
2. Bhowmik DM, Dinda AK, Mahanta P, Agarwal SK. The evolution of the Banff classification schema for diagnosing renal allograft rejection and its implications for clinicians. Indian J Nephrol 2010 Jan; 20 (1): 2–8. doi:10.4103/0971-4065.62086. PubMed PMID: 20535263; PubMed Central PMCID: PMC2878403.
3. Loupy A, Haas M, Mengel M. The Banff 2015 Kidney Meeting Report: Current challenges in rejection classification and prospects for adopting molecular pathology. Am J Transplant 2017 Jan; 17 (1): 28–41. doi: 10.1111//ajt.14107. PubMed PMID: 27862883.
4. Smith RN, Kawai T, Boskovic S, et al. Four stages and lack of stable accommodation in chronic alloantibody-mediated renal allograft rejection in Cynomolgus monkeys. Am J Transplant 2008 Aug; 8 (8): 1662–-1672. doi: 10.1111/j.1600-6143.2008.02303.x. Epub 2008 Jun 28. PubMed PMID: 18557724; PubMed Central PMCID: PMC2796366.
5. Kim JJ, Balasubramanian R, Marks SD. The clinical spectrum of de novo donor-specific antibodies in pediatric renal transplant recipients. Am J Transplant 2014 Oct; 14 (10): 2350–2358. doi: 10.1111/ajt.12859. PubMed PMID: 25167892.
6. Loupy A, Suberbielle-Boissel C, Nochy D. Outcome of subclinical antibody-mediated rejection in kidney transplant recipients with preformed donor-specific antibodies. Am J Transplant 2009 Nov; 9 (11): 2561–2570. doi: 10.1111/j.1600-6143.2009.02813.x. PubMed PMID: 19775320.
7. Loupy A, Vernerey D, Lefaucheur C. Subclinical rejection phenotypes at 1 year post-transplant and outcome of kidney allografts. J Am Soc Nephrol 2015 Jul; 26 (7): 1721–1731. doi: 10.1681/ASN.2014040399. PubMed PMID: 25556173; PubMed Central PMCID: PMC4483584.
8. Wiebe C, Gibson IW, Nickerson PW. Evolution and clinical pathologic correlations of de novo donor-specific HLA antibody post kidney transplant. Am J Transplant 2012 May; 12 (5): 1157–1167. doi: 10.1111/j.1600-6143.2012.04013.x. PubMed PMID: 22429309.
9. Arias M, Rush DN, Schwaiger E. Antibody-mediated rejection: analyzing the risk, proposing solutions. Transplantation 2014 Aug 15; 98 (Suppl 3): S3–21. doi: 10.1097/TP.0000000000000218. PubMed PMID: 25093441.
10. Lefaucheur C, Viglietti D, Zeevi A. IgG donor-specific anti-human HLA antibody subclasses and kidney allograft antibody-mediated injury. J Am Soc Nephrol 2016 Jan; 27 (1): 293–304. doi: 10.1681/ASN.2014111120. PubMed PMID: 26293822; PubMed Central PMCID: PMC4696574.
11. Otten HG, Verhaar MC, Borst HP, et al. Pretransplant donor-specific HLA class-I and -II antibodies are associated with an increased risk for kidney graft failure. Am J Transplant 2012 Jun; 12 (6): 1618–1623. doi:10.1111/j.1600-6143.2011.03985.x. Epub 2012 Mar 8. PubMed PMID: 22404993.
12. Rusai K, Dworak J, Müller-Sacherer T. Donor-specific HLA antibodies and graft function in kidney-transplanted children – the Vienna cohort. Pediatr Transplant 2016 Jun; 20 (4): 507–514. doi: 10.1111/petr.12707. PubMed PMID: 27089840.
13. Yell M, Muth BL, Ellis TM. C1q Binding activity of de novo donor-specific HLA antibodies in renal transplant recipients with and without antibody-mediated rejection. Transplantation 2015 Jun; 99 (6): 1151–1155. doi: 10.1097/TP.0000000000000699. PubMed PMID: 25839705
14. Sicard A, Ducreux S, Thaunat O. Detection of C3d-binding donor-specific anti-HLA antibodies at diagnosis of humoral rejection predicts renal graft loss. J Am Soc Nephrol 2015 Feb; 26 (2): 457–467. doi: 10.1681//ASN.2013101144. PubMed PMID: 25125383; PubMed Central PMCID: PMC4310653.
15. Bailly E, et al. Prognostic value of the persistence of C1q-binding anti-HLA antibodies in acute antibody-mediated rejection in kidney transplantation. Transplantation 2018 Apr; 102 (4): 688–698. doi: 10.1097/TP.0000000000002002. PubMed PMID: 29135832.
16. Kim JJ, et al. Clinical risk stratification of paediatric renal transplant recipients using C1q and C3d fixing of de novo donor-specific antibodies. Pediatr Nephrol 2018 Jan; 33 (1): 167–174. doi: 10.1007/s00467-017-3772-7. Epub 2017 Sep 16. PubMed PMID: 28918487; PubMed Central PMCID: PMC5700253.
17. Guidicelli G, Guerville F, Lepreux S, et al. Non-complement-binding de novo donor-specific anti-HLA antibodies and kidney allograft survival. J Am Soc Nephrol 2016 Feb; 27 (2): 615–625. doi: 10.1681//ASN.2014040326. Epub 2015 Jun 5. PubMed PMID: 26047793; PubMed Central PMCID: PMC4731103.
18. Feucht HE, Felber E, Albert E. Vascular deposition of complement-split products in kidney allografts with cell-mediated rejection. Clin Exp Immunol 1991 Dec; 86 (3): 464–470. PubMed PMID: 1747954; PubMed Central PMCID: PMC1554190.
19. Feucht HE, Schneeberger H, Albert E. Capillary deposition of C4D complement fragment and early renal graft loss. Kidney Int 1993 Jun; 43 (6): 1333–1338. PubMed PMID: 8315947.
20. Honsová E. Antibody-mediated rejection of renal allograft and the update Banff classification 2013. Cesk Patol 2015; 51 (3): 116–119. Czech PubMed PMID: 26421951.
21. Gibson IW, Gwinner W, Bröcker V, et al. Peritubular capillaritis in renal allografts: prevalence, scoring system, reproducibility and clinicopathological correlates. Am J Transplant 2008 Apr; 8 (4): 819–825. doi: 10.1111/j.1600-6143.2007.02137.x. Epub 2008 Feb 5. PubMed PMID: 18261174.
22. Slatinská J, Viklický O. Protilátkami zprostředkovaná rejekce: současné pohledy na patofyziologii a terapii. Aktuality v nefrologii (AVN) 2014; 20 (1): 20–30. Dostupné na World Wide Web: http://www.tigis.cz/images/stories/Aktuality_nefro/2014/01/04_slatinska_avn_1-14.pdf
23. Pape L, Becker JU, Immenschuh S, Ahlenstiel T. Acute and chronic antibody-mediated rejection in pediatric kidney transplantation. Pediatr Nephrol 2015 Mar; 30 (3): 417–424. doi: 10.1007/s00467-014-2851-2. Epub 2014 May 28. Review. PubMed PMID: 24865478.
24. Ng YW, Singh M, Sarwal MM. Antibody-mediated rejection in pediatric kidney transplantation: pathophysiology, diagnosis, and management. Drugs 2015 Apr; 75 (5): 455–472. doi: 10.1007/s40265-015-0369-y. Review. PubMed PMID: 25813498.
25. Puttarajappa C, Shapiro R, Tan HP. Antibody-mediated rejection in kidney transplantation: a review. J Transplant 2012; 2012: 193724. doi: 10.1155/2012/193724. PubMed PMID: 22577514; PubMed Central PMCID: PMC3337620.
26. Bartel G, Schwaiger E, Böhmig GA. Prevention and treatment of alloantibody-mediated kidney transplant rejection. Transpl Int 2011 Dec; 24 (12): 1142–1155. doi: 10.1111/j.1432-2277.2011.01309.x. Epub 2011 Aug 10. Review. PubMed PMID: 21831227.
27. Lefaucheur C, Nochy D, Suberbielle-Boissel C. Comparison of combination Plasmapheresis/IVIg/anti-CD20 versus high-dose IVIg in the treatment of antibody-mediated rejection. Am J Transplant 2009 May; 9 (5): 1099–1107. doi: 10.1111/j.1600-6143.2009.02591.x. PubMed PMID: 19422335.
28. Kaposztas Z, Podder H, Kahan BD. Impact of rituximab therapy for treatment of acute humoral rejection. Clin Transplant 2009 Jan-Feb; 23 (1): 63–73. doi: 10.1111/j.1399-0012.2008.00902.x. PubMed PMID: 19200217.
29. Billing H, Rieger S, Tönshoff B. Successful treatment of chronic antibody-mediated rejection with IVIG and rituximab in pediatric renal transplant recipients. Transplantation 2008 Nov 15; 86 (9): 1214–1221. doi: 10.1097/TP.0b013e3181880b35. PubMed PMID: 19005402.
30. Gulleroglu K, Baskin E, Haberal M. Antibody-mediated rejection and treatment in pediatric patients: one center‘s experience. Exp Clin Transplant 2013 Oct; 11 (5): 404–407. PubMed PMID: 24128133.
31. Waiser J, Budde K, Lachmann N. Comparison between bortezomib and rituximab in the treatment of antibody-mediated renal allograft rejection. Nephrol Dial Transplant 2012 Mar; 27 (3): 1246–1251. doi: 10.1093/ndt//gfr465. PubMed PMID: 21852274.
32. Waiser J, Duerr M, Lachmann N. Rituximab in combination with bortezomib, plasmapheresis, and high-dose IVIG to treat antibody-mediated renal allograft rejection. Transplant Direct 2016 Jul 1; 2 (8): e91. PubMed PMID: 27819032; PubMed Central PMCID: PMC5083001.
33. Pearl MH, Nayak AB, Tsai EW. Bortezomib may stabilize pediatric renal transplant recipients with antibody-mediated rejection. Pediatr Nephrol 2016 Aug; 31 (8): 1341–1348. doi: 10.1007/s00467-016-3319-3. PubMed PMID: 27048228.
34. Locke JE, et al. The use of antibody to complement protein C5 for salvage treatment of severe antibody-mediated rejection. Am J Transplant 2009 Jan; 9 (1): 231–235. doi: 10.1111/j.1600-6143.2008.02451.x. Epub 2008 Oct 31. PubMed PMID: 18976298.
35. Stegall MD, Diwan T, Gloor JM. Terminal complement inhibition decreases antibody-mediated rejection in sensitized renal transplant recipients. Am J Transplant. 2011 Nov; 11 (11): 2405–2413. doi: 10.1111/j.1600-6143.2011.03757.x. Erratum in: Am J Transplant 2013 Jan; 13 (1): 241. PubMed PMID: 21942930.
36. Chehade H, Rotman S, Pascual M. Eculizumab to treat antibody-mediated rejection in a 7-year-old kidney transplant recipient. Pediatrics 2015 Feb; 135 (2): e551–555. doi: 10.1542/peds.2014-2275. PubMed PMID: 25624380.
37. Ghirardo G, Benetti E, Murer L. Plasmapheresis-resistant acute humoral rejection successfully treated with anti-C5 antibody. Pediatr Transplant 2014 Feb; 18 (1): E1–5. doi: 10.1111/petr.12187. PubMed PMID: 24266980.
38. Barnett AN, Asgari E, Chowdhury P, et al. The use of eculizumab in renal transplantation. Clin Transplant 2013 May-Jun; 27 (3): E216–229. doi: 10.1111/ctr.12102. Epub 2013 Mar 21. Review. PubMed PMID: 23516966.
39. Burbach M, Suberbielle C, Hertig A. Report of the inefficacy of eculizumab in two cases of severe antibody-mediated rejection of renal grafts. Transplantation 2014 Nov 27; 98 (10): 1056–1059. doi: 10.1097//TP.0000000000000184. PubMed PMID: 24839895.
40. Locke JE, et al. The utility of splenectomy as rescue treatment for severe acute antibody mediated rejection. Am J Transplant 2007 Apr; 7 (4): 842–846. PubMed PMID:17391127.
Labels
Neonatology Paediatrics General practitioner for children and adolescentsArticle was published in
Czech-Slovak Pediatrics
2019 Issue 6
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